Frequency, severity and persistence of postnatal dyspareunia to 18 months post partum: A cohort study

Objective: to describe the frequency, severity and persistence of dyspareunia in the first 18 months after the birth of a first child. Design: prospective pregnancy cohort study. Setting: Melbourne, Victoria, Australia. Population: 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. Outcome measures: 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. Findings: 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. (C) 2016 Elsevier Ltd. All rights reserved.