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Critical Reviews™ in Physical and Rehabilitation Medicine
SJR: 0.121 SNIP: 0.228 CiteScore™: 0.5

ISSN Print: 0896-2960
ISSN Online: 2162-6553

Critical Reviews™ in Physical and Rehabilitation Medicine

DOI: 10.1615/CritRevPhysRehabilMed.v11.i2.20
28 pages

Persistent Postnatal Perineal Pain and Dyspareunia: A Review of Physical Pathology and Treatment

E. J. C. Hay-Smith
School of Physiotherapy, Division of Health Sciences, University of Otago, P. 0. Box 56, Dunedin, New Zealand
C. M. A. Glazener
Health Service Research Unit, University of Aberdeen, Poiwarth Building, Medical School, Foresterhill, Aberdeen, AB25 2ZD, Scotland


Postnatal perineal pain and dyspareunia are common. For many women the problem will resolve spontaneously within 3 months of delivery. However, a small but significant minority develops persistent perineal pain and/or dyspareunia, and this has considerable impact on the sexual function of women and their partners. Some women may be more at risk of postnatal dyspareunia (e.g., primiparae, or after assisted vaginal delivery). Less than half with the problem are likely to actively seek treatment from, or be offered treatment by, a health care professional. Those in regular contact with postnatal women should consider taking a proactive role in identifying women with a range of postnatal morbidities, including persistent perineal pain and dyspareunia. There is very little literature outlining the assessment and management of dyspareunia in the postnatal population. Physiotherapists potentially have skills appropriate to the assessment and management of postnatal dyspareunia, particularly where the primary problem appears to be pain originating from scar tissue, but there is insufficient evidence available at present to support or dismiss this contention. In view of the lack of research currently available, it is not possible to make evidence-based recommendations for practice. Essentially, there is considerable need for further research in all aspects of postnatal dyspareunia.

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