Introduction
Dyspareunia, a common complaint, reported by 7.5% of sexually active women (1), is a multifactorial bio-psychosocial phenomenon and carries extensive physical, mental and social implications. Causes include bio-medical factors such as vulvovaginal skin conditions, iatrogenic factors, and hormonal changes (2). The most common aetiologies of long-standing dyspareunia are provoked vestibulodynia (PVD), a chronic vulvar pain condition, with prevalence ranges of 10%-28% in women of reproductive age (3,4), and vaginismus, a reflexive, involuntary pelvic muscle tightening with prevalence ranges of 5%-17% (5).
Despite the high prevalence of dyspareunia, surprisingly few studies have addressed reproductive function in women with this condition, with inconsistent results. Some studies have shown dyspareunia to be related to a higher need for assisted reproductive techniques (ART) (7,8), while others have not identified such an association (9). Studies in women with dyspareunia have observed a higher risk for cesarean section, instrumental delivery (8) and perineal lacerations (10,11). Women with dyspareunia were also found to experience postpartum perineal pain longer than comparisons (9).
So far, studies on reproductive outcomes in women with dyspareunia have focused mainly on obstetrical parameters. There are indications that women with dyspareunia express fear of delivery (12), yet reports on their actual experience of labor are restricted to pain and anxiety levels and largely based on midwives’ impressions (11). Excluding a single study which used a qualitative methodology (13), no research has focused on emotional and cognitive parameters or on maternal adjustment after childbirth in women with dyspareunia. The aim of this study was to assess obstetrical outcomes, perceptions of childbirth experience and emotional adjustment following childbirth, among women with a history of dyspareunia.