title: Frequency, severity and persistence of postnatal dyspareunia to 18 months post partum: A cohort study.
abstract: OBJECTIVE
  to describe the frequency, severity and persistence of dyspareunia in the first 18 months after the birth of a first child.
  
  
  METHODS
  prospective pregnancy cohort study.
  
  
  METHODS
  Melbourne, Victoria, Australia.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
authors.affiliation: Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Melbourne, Australia. Electronic address: ellie.mcdonald@mcri.edu.au.
authors.forename: Ellie A
authors.initials: EA
authors.lastname: McDonald
authors.affiliation: Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Melbourne, Australia.
authors.forename: Deirdre
authors.initials: D
authors.lastname: Gartland
authors.affiliation: The Judith Lumley Centre, La Trobe University, Melbourne, Australia.
authors.forename: Rhonda
authors.initials: R
authors.lastname: Small
authors.affiliation: Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Melbourne, Australia; Academic Centre for General Practice and Primary Health Care, University of Melbourne, Australia.
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Brown
mesh_terms: D000293:Adolescent; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000009:adverse effects*; D004414:Dyspareunia / Q000453:epidemiology* / Q000209:etiology / Q000451:nursing / Q000473:pathology; D005260:Female; D006801:Humans; D008880:Midwifery; D011181:Postnatal Care; D049590:Postpartum Period; D011247:Pregnancy; D011644:Puerperal Disorders / Q000453:epidemiology* / Q000209:etiology / Q000451:nursing / Q000473:pathology; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014739:Victoria / Q000453:epidemiology; D055815:Young Adult
keywords: Cohort studies; Description of pain; Dyspareunia; Pain during sex; Postpartum period; Sexual intercourse