Dyspareunia and sexual dysfunction after vaginal delivery in Thai primiparous women with episiotomy

Abstract

Introduction: Episiotomy remains commonly practiced in Thailand. There are limited data on its impacts on sexuality among Asian women during the first postdelivery year.

Aims: The aim was to study dyspareunia and sexual function at 3-12 months after vaginal delivery in Thai primiparous women with episiotomy.

Methods: A total of 190 participants were approached on Day 2 postpartum. Of these, 93 sexually active women were evaluated for dyspareunia and sexual function at 3 months by using 10-cm visual analog scale and the validated Thai version of Female Sexual Function Index (TFSFI). TFSFI < 26.5 was defined as having potential sexual dysfunction. At 6 and 12 months, sexual function was evaluated by telephone interview.

Main outcome measures: The prevalence of dyspareunia at 3 months and the changes of TFSFI scores during the first postdelivery year were the main outcome measures.

Results: The average age of the participants, over 90% of whom were high school finishers, was 24. Their partners were around 3 years older, and the median partnership duration was 3 years. At 3 months, 30.1% of participants reported dyspareunia. There was no association between dyspareunia and the following characteristics: pre-pregnancy dyspareunia, newborn's head circumference and birthweight and breast-feeding (P > 0.05 for all). Sexual dysfunction was demonstrated in 66.7% at 3 months, 31.0% at 6 months, and 14.9% at 12 months. From 3 to 12 months, the median TFSFI scores in all domains increased significantly. There was no difference of the scores in all domains at 3 and 12 months between women with and without dyspareunia at 3 months. However, at 6 months, those without dyspareunia had better scores in pain, orgasm, satisfaction, and total scores (P < 0.05 for all).

Conclusion: Dyspareunia at 3 months is common in Thai primiparous women with episiotomy. Those with dyspareunia have a slower resumption of normal sexual function.

Keywords: Dyspareunia; Episiotomy; Primiparous; Sexual Function.