Dyspareunia and pelvic floor muscle function before and during pregnancy and after childbirth

Abstract

This file was dowloaded from the institutional repository Brage NIH -brage.bibsys.no/nih Tennfjord, M. K., Hilde, G., Staer-Jensen, J., Ellstrøm Engh, M., Bø, K. (2014).Dyspareunia and pelvic floor muscle function before and during pregnancy and during pregnancy and after childbirth. ABSTRACT Introduction and hypothesis:There is limited knowledge on dyspareunia during pregnancy and postpartum and the role of the pelvic floor muscles (PFM) in women with dyspareunia. Aims of the study were to investigate presence of dyspareunia before, during pregnancy and postpartum and to compare vaginal resting pressure (VRP), PFM strength and endurance between women with and without dyspareunia. It was hypothesized that there is no difference in PFM variables between women with and without dyspareunia. Methods: Three hundred nulliparous women participated in this prospective cohort and answered questions about dyspareunia and level of bother at gestational weeks 22 and 37, 6 and 12 months postpartum and retrospectively prior to their pregnancies using ICIQFLUTSsex. PFM variables were assessed by manometer at gestational week 22, 6 and 12 months postpartum. Comparisons between groups were analyzed using independent-samples t test.Results: Twenty-eight and 30% of the women reported dyspareunia at pre-pregnancy and at gestational week 22, respectively. At gestational week 37, 6 and 12 months postpartum, the number was 40%, 45% and 33%, respectively. No difference in PFM variables were found between women with or without dyspareunia. Level of bother was higher postpartum than before and during pregnancy. Conclusion: Symptoms of dyspareunia were common at all time points. No link could be made between PFM function and dyspareunia. Women suffering from dyspareunia postpartum reported it as bothersome. Our findings suggest that women should be asked about symptoms of dyspareunia related to pregnancy, and that future research should aim for preventative and treatment strategies.

Pelvic floor muscle strength in primiparous women according to the delivery type: cross-sectional study

“…In this study, most primiparous women returned to sexual activity between 50 and 70 days after delivery and about half of them mentioned dyspareunia, however, as with other studies 10 , 15 , no difference was found in PFMS related to the type of childbirth regarding this complaint.…”

“…No significant difference was identified between the groups in relation to vaginal pressure at rest, perineal muscle strength and vaginal endurance, six and 12 months after delivery. Also, no significant difference was identified between the groups according to the delivery type, episiotomy, third and fourth degree perineal lacerations, or weight of the newborn 10 . …”

Coital Incontinence and Vaginal Symptoms and the Relationship to Pelvic Floor Muscle Function in Primiparous Women at 12 Months Postpartum: A Cross-Sectional Study

“…Mode of delivery gave minimal risk of having sexual dysfunction in this study, except for the women reporting vaginal laxity where vaginal delivery and forceps showed a fourfold increased risk when compared with caesarean section [6]. Dyspareunia has been found to be associated with lacerations following vaginal delivery [7], but the published literature is controversial [6,8,9].…”

“…However, there may also be an overlap of symptoms from the questionnaire ICIQ‐VS, meaning that more symptoms may have similar explanations. No association has been found between PFM function and breastfeeding among the same women [9].…”

“…Vaginal childbirth has been previously shown to be associated with lower vaginal resting pressure (VRP), pelvic floor muscle (PFM) strength, and endurance [10,11]. Low PFM strength has also been found to be related to poorer orgasm and arousal function [12], whereas no link has been found between sexual dysfunction in terms of dyspareunia and VRP, PFM strength, and endurance [9,12]. However, we are not aware of any studies investigating how other vaginal symptoms may be associated with PFM function after childbirth and if there is an association between coital incontinence and PFM function postpartum.…”