Effects of perineal trauma on postpartum sexual function

This article is a report of a study of the extent of postpartum sexual dysfunction associated with perineal trauma.

Sexual health problems are common in the postpartum period but despite this it is a topic that lacks professional recognition. After delivery, many women experience reduced sexual desire and reduced vaginal lubrication, as well as weaker and shorter orgasms.

Women giving birth in the study hospital between 2005 and 2006 and meeting the inclusion criteria were studied, i.e. women at low-risk who expected vaginal delivery at over 38 weeks' gestation with a single foetus in the vertex position. One hundred and sixty-five women were invited for postpartum check-ups 3 months later and 55 attended. A detailed gynaecologic examination was carried out and the perineum was carefully inspected by the same physician. Questionnaires were administered and 20-minute face-to-face interviews were carried out to compare the women's sexual lives before pregnancy and after giving birth.

Compared to women with intact perineum, those who had both episiotomy and second degree perineal tears, had lower levels of libido, orgasm, and sexual satisfaction and more pain during intercourse. The presence of at least one sexual problem (reduced sexual desire, reduced vaginal arousal, reduced vaginal lubrication, reduced frequency of orgasm, dissatisfaction with sexual life and dyspareunia) was statistically significant more common after birth.

Limiting perineal trauma during delivery is important for the resumption of sexual intercourse after childbirth. Routine episiotomy and fundal pressure should be avoided to prevent perineal trauma.