Dyspareunia and Sexual Dysfunction after Vaginal Delivery in Thai Primiparous Women with Episiotomy

Introduction: Episiotomy remains commonly practiced in Thailand. There are limited data on its impacts on sexuality among Asian women during the first postdelivery year. Aims: The aim was to study dyspareunia and sexual function at 3-12 months after vaginal delivery in Thai primiparous women with episiotomy. Methods: A total of 190 participants were approached on Day 2 postpartum. Of these, 93 sexually active women were evaluated for dyspareunia and sexual function at 3 months by using 10-cm visual analog scale and the validated Thai version of Female Sexual Function Index (TFSFI). TFSFI<26.5 was defined as having potential sexual dysfunction. At 6 and 12 months, sexual function was evaluated by telephone interview. Main Outcome Measures: The prevalence of dyspareunia at 3 months and the changes of TFSFI scores during the first postdelivery year were the main outcome measures. Results: The average age of the participants, over 90% of whom were high school finishers, was 24. Their partners were around 3 years older, and the median partnership duration was 3 years. At 3 months, 30.1% of participants reported dyspareunia. There was no association between dyspareunia and the following characteristics: pre-pregnancy dyspareunia, newborn's head circumference and birthweight and breast-feeding (P>0.05 for all). Sexual dysfunction was demonstrated in 66.7% at 3 months, 31.0% at 6 months, and 14.9% at 12 months. From 3 to 12 months, the median TFSFI scores in all domains increased significantly. There was no difference of the scores in all domains at 3 and 12 months between women with and without dyspareunia at 3 months. However, at 6 months, those without dyspareunia had better scores in pain, orgasm, satisfaction, and total scores (P<0.05 for all). Conclusion: Dyspareunia at 3 months is common in Thai primiparous women with episiotomy. Those with dyspareunia have a slower resumption of normal sexual function.