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Frequency, severity and persistence of postnatal dyspareunia to 18 months post partum: A cohort study
Ellie A McDonald1, Deirdre Gartland1, Rhonda Small2
1Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Melbourne, Australia.
Objective:
to describe the frequency, severity and persistence of dyspareunia in the first 18 months after the birth of a first child.
Design:
prospective pregnancy cohort study.
Setting:
Melbourne, Victoria, Australia.
Population:
1507 nulliparous women.
Methods:
women ≤24 weeks gestation were recruited from six public hospitals. Self-administered written questionnaires were completed at recruitment and at three, six, 12 and 18 months post partum.
Outcome Measures:
study-designed self-report measure of dyspareunia on first vaginal sex, and on second and subsequent sex at all time-points, utilising the rating scale from the McGill Pain Intensity Scale.
Findings:
overall, 961/1122 (85.7%) of women experienced pain on first vaginal sex postnatally. The proportion of women experiencing dyspareunia reduced over time, from 431/964 (44.7%) at three months post partum to 261/1155 (22.6%) at 18 months post partum. Of the women who reported dyspareunia at each time-point, around 10% of women described the pain as׳distressing׳,׳horrible׳ or׳excruciating׳. Women who had a caesarean section were more likely to report more intense dyspareunia at six months post partum (aOR=2.35, 95% CI=1.2-4.6).
Conclusions:
postnatal dyspareunia decreases over time, but persists beyond 12 months for one in five women. Caesarean section appears to be associated with more intense dyspareunia.
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