Relationship between delivery modes and genitourinary syndrome among postmenopausal women

Abstract

Objectives: Many postmenopausal women suffer from genitourinary syndrome of menopause (GSM) due to the lack of estrogen. This study aimed to evaluate the relationship between mode of delivery and GSM among postmenopausal women.

Methods: We performed a case–control study of women who had had either vaginal delivery or Cesarean section. Data were collected through a sociodemographic questionnaire and a check list for assessing signs and symptoms of GSM. Subjective symptoms of vaginal atrophy (dryness, dyspareunia, itching, burning and paleness), pH of the vagina and maturation index were assessed and recorded. Data were analyzed using the χ² test and independent t-test.

Results: A total of 125 postmenopausal women were recruited (65 with a history of normal vaginal delivery (NVD) and 60 with a history of Cesarean section). Vaginal pH was more commonly lower (pH 5–5.49) in the NVD group (50.8% vs. 40%) (p < 0.001). The maturation index was also better in the NVD group (42.7 ± 6.34 vs. 24.08 ± 8.2) (p < 0.001). All symptoms of vaginal atrophy including paleness, dryness, itching, dyspareunia and burning were significantly less in the NVD group compared to the Cesarean section group (p < 0.05).

Conclusion: Postmenopausal women with a history of normal vaginal delivery were less likely to have GSM compared to the women with a history of Cesarean section. Other prospective studies can explore this relationship better.

Keywords:

• Genitourinary syndrome
• postmenopausal women
• mode of delivery
• vaginal atrophy
• Cesarean section

Acknowledgements

This study is part of the Master thesis by M. Yaralizadeh. All expenses of this research work were provided by Ahvaz Jundishapur University of Medical Sciences. We would like to thank all women who participated in this study.

Conflict of interest

The authors declare that there is no conflict of interest.

Source of funding

This study was financially supported by Ahvaz Jundishapur University of Medical Sciences.