title: Effects of perineal trauma on postpartum sexual function.
abstract: OBJECTIVE
  This article is a report of a study of the extent of postpartum sexual dysfunction associated with perineal trauma.
  
  
  BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Obstetric and Gynecological Nursing, Florence Nightingale School of Nursing, Istanbul University, Turkey. gulumyil@yahoo.com
authors.forename: Gulay
authors.initials: G
authors.lastname: Rathfisch
authors.forename: Birsen Kucuk
authors.initials: BK
authors.lastname: Dikencik
authors.forename: Nezihe
authors.initials: N
authors.lastname: Kizilkaya Beji
authors.forename: Nadir
authors.initials: N
authors.lastname: Comert
authors.forename: Ali Ismet
authors.initials: AI
authors.lastname: Tekirdag
authors.forename: Ateş
authors.initials: A
authors.lastname: Kadioglu
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health / Q000208:ethnology; D003075:Coitus / Q000502:physiology* / Q000523:psychology; D036861:Delivery, Obstetric / Q000009:adverse effects; D004414:Dyspareunia / Q000453:epidemiology / Q000209:etiology; D004841:Episiotomy / Q000009:adverse effects; D005260:Female; D006801:Humans; D007989:Libido / Q000502:physiology; D008297:Male; D009948:Orgasm / Q000502:physiology; D010502:Perineum / Q000293:injuries*; D049590:Postpartum Period / Q000502:physiology* / Q000523:psychology; D011247:Pregnancy; D011446:Prospective Studies; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology* / Q000209:etiology / Q000451:nursing; D011795:Surveys and Questionnaires; D013997:Time Factors; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult