Prevalence of sexual health issues in first time mothers and associated risk factors

Background Approximately 20%-30% of women experience some sexual health issues at 6 months postpartum, and these issues persist for 20% of these women at 12 months postpartum. There are no data on the prevalence of women’s... [ view full abstract ]

Background
Approximately 20%-30% of women experience some sexual health issues at 6 months postpartum, and these issues persist for 20% of these women at 12 months postpartum. There are no data on the prevalence of women’s sexual health issues before, during or after pregnancy in Ireland, making comparisons with international literature impossible.

Aim and objectives
To identify the prevalence of sexual health issues in nulliparous women during the first year postpartum and determine associated risk factors.

Methods
A longitudinal, cohort study was used to collect data on a range of maternal health and morbidity outcomes during pregnancy and 3, 6, 9 and 12 months postpartum. Findings from surveys completed at 6 and 12 months by 832 women were analysed. Descriptive statistics were used to determine prevalence of sexual health issues. Univariate regression analysis was used to determine associations between sexual health issues and risk factors including; mode of birth, perineal trauma and breastfeeding.

Findings
Dyspareunia increased immediately postpartum and was less than pre-pregnancy levels at 12 months postpartum. Having a 3rd degree perineal tear and an episiotomy were significant risk factors for dyspareunia 6 months postpartum, while ventouse-assisted birth was associated with persistent dyspareunia at 6 months (OR1.5 95% 1.0-2.4) and 12 months (OR1.7 95% 1.0-2.8).

Prevalence of lack of vaginal lubrication increased from pre-pregnancy (36.6%) to 43% at 6 months reducing to 35.4% at 12 months. There was a significant association between a lack of vaginal lubrication and ventouse-assisted birth at 6 months and with breastfeeding at 6 months postpartum (OR 1.6 95% 1.2-2.3).

A loss of interest in sexual activity persisted up to 12 months after birth, with a 2nd degree tear and breastfeeding at 6 months significantly associated with a loss of interest in sexual activity 6 months after birth.

Conclusion
Women require information on factors associated with postpartum sexual health issues. Health professionals can provide individually tailored practical advice with this knowledge and appropriate referrals can be made when women experienced persistent sexual health issues that become problematic.