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Sexual Function 6 Months After First Delivery

From the ¹Departments of Obstetrics/Gynecology and Urology, Loyola University Medical Center, Maywood, Illinois; ²Department of Obstetrics and Gynecology, Johns Hopkins University, Baltimore, Maryland; ³Department of Obstetrics and Gynecology, University of Iowa, Iowa City, Iowa; ⁴Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; ⁵Department of Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, Pennsylvania; ⁶Department of Biostatistics, University of Michigan, Ann Arbor, Michigan; and ⁷National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.

OBJECTIVE: To explore the association of anal sphincter laceration and sexual function 6 months postpartum in the Childbirth and Pelvic Symptoms (CAPS) cohort.

METHODS: The primary CAPS study, a prospective cohort study, was designed to estimate the postpartum prevalence and incidence of urinary and fecal incontinence. Three cohorts of new mothers (vaginal delivery with a third- or fourth-degree anal sphincter tear, vaginal delivery without a third- or fourth-degree anal sphincter tear, and cesarean delivery without labor) were compared at 6 months postpartum. Sexual function was assessed with the Pelvic Organ Prolapse/Urinary Incontinence/Sexual Function Short Form Questionnaire (PISQ-12). Urinary and fecal incontinence were assessed using the Medical Epidemiological and Social Aspects of Aging questionnaire and the Fecal Incontinence Severity Index, which is embedded within the Modified Manchester Health Questionnaire.

RESULTS: Most women (459 [90%]) of those with partners reported sexual activity at the 6-month visit. Fewer women whose delivery was complicated by anal sphincter laceration reported sexual activity when compared with those who delivered vaginally without sphincter laceration (88 compared with 94%, P=.028). The mean PISQ-12 score (39±4) did not differ between delivery groups (P=.92). Pain (responses of "sometimes," "usually," or "always") during sex affected one of three sexually active women (164 [36%]).

CONCLUSION: At 6 months postpartum, primiparous women who delivered with anal sphincter laceration are less likely to report sexual activity.

LEVEL OF EVIDENCE: II

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				P. J. Culligan The Impact of Pelvic Floor Dysfunction on Sexuality: How Should We Counsel Our Patients? Obstet. Gynecol., May 1, 2008; 111(5): 1037 - 1038. [Full Text] [PDF]