Targeted treatment relieves pain in women with postpartum dyspareunia

Dyspareunia, or pain during sexual intercourse, normally occurs after giving birth, but many women do not discuss the condition with their doctors, according to a study. Targeted treatment can help improve this condition.

A group of researchers conducted a retrospective observational study of women diagnosed with postpartum dyspareunia between September 2008 and January 2017 at a single designated vulvovaginal disorder clinic. Those with complaint of painful intercourse commencing postdelivery were included.

Eligible participants (n=100) were divided into four groups based on the causes of dyspareunia: muscle hypertonicity, scar tenderness, vestibular tenderness, and atrophy.

The researchers assessed patient background demographics, clinical and obstetric data, physical findings, recommended therapy, adherence to the suggested treatment, level of improvement at follow-up visits, and length of time until maximal improvement for each group.

Majority of the women (n=60) presented with more than one causative factor. The most common finding was vestibular tenderness (78 percent), which significantly correlated with atrophy (adjusted odds ratio [aOR], 15.08, 95 percent confidence interval [CI], 2.45‒93.35), contraceptive usage (aOR, 4.76, 95 percent CI, 1.07‒21.39), and primiparity (aOR, 4.89, 95 percent CI, 1.01‒23.88).

The only risk factor for scar tenderness was episiotomy (aOR, 5.43, 95 percent CI, 1.20‒24.53), while the existence of a spontaneous perineal tear was not. No specific association with pelvic floor muscle hypertonicity was observed.

Notably, targeted treatment significantly improved the condition in most patients.

“[I]t is important to assess this condition (postpartum dyspareunia) with all women during the postpartum visit as targeted diagnosis and treatment can significantly improve outcomes,” the researchers said.