Postpartum dyspareunia. An unexplored problem.
OBJECTIVE
Postpartum dyspareunia has been attributed by authors of obstetric texts to episiotomy tenderness or vaginal atrophy. The nursing literature attributes it to low estrogen levels. This study attempts to examine these assumptions, to clarify the incidence of postpartum dyspareunia and the length of time it is likely to last.


METHODS
Sixty-two women in a private practice were examined between two and eight weeks postpartum and followed prospectively.


RESULTS
Forty-five percent of parturients developed entry dyspareunia, but only 6% had pain at the sites of vulvar repair. The median length of symptoms in the 39% with nonfocal introital dyspareunia was 5.5 months, and tenderness lasted up to 1 year. Such dyspareunia developed in women having a first (42%) or second (47%) infant, delivering vaginally (42%) or by cesarean section (29%), and lactating (41%) or not lactating (22%). One-third of those affected had severe sexual dysfunction.


CONCLUSIONS
Postpartum dyspareunia is quite common and can be a significant source of difficulty in the months after delivery. It is an underdetected problem and deserves more study.
Goetsch
M F
MF
Department of Obstetrics and Gynecology, Legacy Good Samaritan Hospital and Medical Center, Portland, Oregon 97210, USA.
D000293:Adolescent; D000328:Adult; D004414:Dyspareunia / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D049590:Postpartum Period; D011247:Pregnancy; D011446:Prospective Studies; D014845:Vulvar Diseases / Q000150:complications / Q000209:etiology / Q000473:pathology