Postpartum dyspareunia and sexual functioning: a prospective cohort study

Abstract

Objectives: Sexual functioning is an important concern for women in the postpartum period. The aim of this research was to investigate the prevalence and determinants of dyspareunia and sexual dysfunction before and after childbirth.

Methods: Between November 2013 and April 2014, 109 women in their third trimester of pregnancy were enrolled in a prospective cohort study at Ghent University Hospital. Dyspareunia, sexual functioning and quality of life (QOL) were evaluated at enrolment and again 6 weeks and 6 months postpartum. Sexual functioning and QOL were assessed using validated self-report questionnaires: the Female Sexual Function Index and the Short Form-36 health survey. Dyspareunia was evaluated by a specific self-developed questionnaire.

Results: One hundred and nine women were enrolled; respectively, 71 (65.1%), 66 (60.6%) and 64 (58.7%) women returned the questionnaires prepartum, and 6 weeks and 6 months postpartum. Sexual functioning at 6 weeks was predictive of sexual functioning at 6 months postpartum (r_s = 0.345, p = .015). The prevalence of dyspareunia in the third trimester of pregnancy, and 6 weeks and 6 months postpartum was, respectively, 32.8%, 51.0% and 40.7%. The severity of pain decreased significantly between 6 weeks and 6 months postpartum (p = .003). In the first 6 weeks postpartum, the degree of dyspareunia was significantly associated with breastfeeding (p = .045) and primiparity (p = .020). At 6 months, only the association with primiparity remained significant (p = .022).

Conclusions: The impaired postpartum sexual functioning, the high prevalence of dyspareunia postpartum and their impact on QOL indicate the need for further investigation and extensive counselling of pregnant women, especially primiparous women, about sexuality after childbirth.

Chinese abstract

目的：性功能是女性产后一项重要的问题。本研究的目的是探讨产前和产后性交困难和性功能障碍的患病率和决定因素。

方法：从2013年11月至2014年4月, 根特大学医院招募109名孕晚期的女性。性交困难、性功能和生活质量（QOL）分别在招募时、产后6周和6个月时进行评估。采用有效的自身调查问卷评估性功能和QOL：女性性功能指数和简表-36健康调查。性交困难由特定的自身调查问卷评估。

结果：招募109名女性；分别有71 （65.1%）, 66（60.6%）和64（58.7%）名女性在产前、产后6周、6个月返回了调查问卷。6周的性功能可以预测产后的性功能（r_s=0.345, p=.015）。孕晚期、产后6周和6个月的性交困难患病率分别为32.8%, 51.0%和40.7%。产后6周到6个月时疼痛程度显著降低（p=.003）。在产后第一个6周, 性交困难的程度与哺乳（p=.045）和初产（p=.020）显著相关。产后6个月时, 只与初产相关（p=.022）。

结论：产后性功能受损、性交困难高患病率及其对QOL的影响需要进一步研究, 对妊娠妇女, 尤其是初产妇女, 需要广泛咨询其产后的性功能。

Keywords:

• Dyspareunia
• FSFI
• postpartum period
• pregnancy
• quality of life
• sexual dysfunction

Disclosure statement

The authors declare that there is no duality of interest associated with this manuscript.