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Sexuality after Delivery with Episiotomy: A Long-Term Follow-Up

Aim: To investigate the quality of women’s sex life 12–18 months after first, episiotomy-assisted childbirth and risk factors for long-term dyspareunia after childbirth. Methods: Two hundred and six women who gave birth vaginally at the Karolinska University Hospital between September 1997 and February 1998 and from June 1998 to January 1999 received postal questionnaires at 12–18 months postpartum. Obstetrical, psychological and sexological data, concerning 110 primiparae who underwent episiotomy and 153 age-matched women who did not, were compared. Possible risk factors for postpartum dyspareunia were investigated in the entire sample. Results: Women who underwent episiotomy experienced a more complicated and emotionally difficult delivery. They reported a higher frequency of dyspareunia and insufficient lubrication than women who had given birth without episiotomy. Arousal, orgasm and satisfaction with sex were not affected. Episiotomy, perineal lacerations, fundal pressure at delivery and a history of dyspareunia were independent risk factors for dyspareunia 12–18 months postpartum. Conclusion: Episiotomy may affect women’s sex life during the second year post partum with more frequent pain and vaginal dryness at intercourse. Other obstetrical factors and pain history may also influence the propensity for dyspareunia.