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Postpartum and Lactation-Related Genitourinary Symptoms: A Systematic Review.
Sara Perelmuter1, Cameron Stokes, Meghana Chapalamadugu
1Weill Cornell Medical College, New York, and the University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York; the Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, Texas; the University of Miami Miller School of Medicine, Miami, and the Center for Vulvovaginal Disorders Florida, Obstetrics and Gynecology, Tampa, Florida; Fundacao Tecnico Educacional Souza Marques, Rio de Janeiro, Brazil; the Michael G. DeGroote School of Medicine, Hamilton, Ontario, Canada; the Hackensack Meridian School of Medicine, Clifton, New Jersey; the David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; the Loyola University Chicago Stritch School of Medicine and the University of Illinois at Chicago College of Medicine, Chicago, Illinois; the Department of Urology, Indiana University, Indianapolis, Indiana; the Sackler School of Medicine/Tel Aviv University, Tel Aviv, Israel; the Burrell College of Osteopathic Medicine, Las Cruces, New Mexico; and the Department of Urology, Georgetown University, Washington, DC.
Lactation significantly impacts genitourinary health, causing vaginal atrophy and dryness in most postpartum individuals. Sexual dysfunction is also highly prevalent, affecting a large proportion of breastfeeding women.
Area of Science:
- Reproductive Health
- Gynecology
- Postpartum Care
Background:
- Lactation-induced hormone deficiency can lead to genitourinary symptoms.
- Understanding the prevalence of these symptoms is crucial for postpartum care.
Purpose of the Study:
- To systematically review the prevalence of genitourinary syndrome of lactation (GSL).
- To assess associated symptoms including vaginal dryness, atrophy, urinary issues, dyspareunia, and sexual dysfunction in postpartum lactating individuals.
Main Methods:
- Systematic review following PRISMA guidelines.
- Comprehensive database search (PubMed, Scopus, etc.) up to April 2024.
- Inclusion of studies on postpartum individuals assigned female at birth, excluding those on hormone therapy or with hormonal disorders.
Main Results:
- Prevalence of vaginal atrophy: 63.9%; vaginal dryness: 53.6%.
- Dyspareunia prevalence at 3, 6, and 12 months postpartum: 60.0%, 39.7%, and 28.5% respectively.
- Pooled prevalence of sexual dysfunction: 73.5%; mean FSFI score: 21.5 (indicating dysfunction).
Conclusions:
- Lactation significantly affects genitourinary health due to hormone deficiency.
- Vaginal atrophy, dryness, and sexual dysfunction are highly prevalent among lactating postpartum individuals.
- These findings underscore the need for awareness and management strategies for GSL.
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