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Updated: Sep 3, 2026
Anogenital Distance and Perineal Measurements of the Pelvic Organ Prolapse (POP) Quantification System
Published on: September 20, 2018
Postpartum Sexual Function in Women with Intrapartum Pelvic Floor Muscle Trauma
Patti Berg-Poppe1, Matthew A Barker2,3, Katelin Soodsma3
1Dakota Department of Physical Therapy, University of South, 414 East Clark, Vermillion South, SD, 57069, USA. Patti.Berg@usd.edu.
Introduction And Hypothesis:
Sexual dysfunction in postpartum women is common, yet the impact of intrapartum pelvic floor trauma (PFT) on domain-specific sexual recovery remains unclear, and pelvic floor physical therapy (PFPT) referral patterns in this population are poorly characterized. This study compared postpartum sexual function trajectories from 2 to 6 months in women with and without intrapartum PFT and examined PFPT referral and utilization.
Methods:
Participants were recruited from Midwest hospitals in the USA at discharge, postpartum visits, and well-baby checkups. Eligibility required age ≥18, vaginal delivery, English fluency, internet access, and follow-up availability. Women with ≥ grade 2 perineal tears were classified as having PFT. Baseline and follow-up surveys included the Carol Scale and FSFI-9, with Wilcoxon signed-rank and Mann-Whitney U tests used for analyses.
Results:
Eighty-six women (45 PFT, 41 no-PFT) completed both timepoints. Overall sexual function, lubrication readiness, and vulvar caressing discomfort improved (all p ≤ .020), whereas libido worsened (p = 0.009). Penetration-related pain did not change. Groups did not differ at baseline; at follow-up, women with PFT reported poorer overall function, lubrication, penetration pain, and post-activity pain (p = 0.020 to 0.041). Recovery trajectories were parallel, with the only difference in change magnitude being greater improvement in intercourse pain in the PFT group (p = 0.039). Among participants reporting PFPT access, only 33.9% were both referred and seen; 86.9% of those who received PFPT reported symptom improvement.
Conclusions:
Women with PFT carried a higher residual symptom burden at 6 months, despite recovery trajectories parallel to those without PFT. Penetration-related pain was the most persistent symptom. Low PFPT referral rates represent a critical and actionable care gap. Postpartum sexual health assessments should include domain-specific screening for penetration-related discomfort and libido, with proactive follow-up for women with PFT and early referral to PFPT.
