Clinical Trial: Postpartum Dyspareunia Resulting From Vaginal Atrophy

Study Status: Completed
Recruit Status: Completed
Study Type: Observational

Official Title: Postpartum Dyspareunia Resulting From Vaginal Atrophy: Prevalence, Characteristics and Risk Factors

Brief Summary:

Postpartum dyspareunia (PD) is a recognized phenomenon: it is estimated that 50-60% of women have dyspareunia 6 to 7 weeks following delivery, and 33% and 17% will still report pain during intercourse three and six months after delivery, respectively.

Studies that evaluated the prevalence and the causes for PD referred primarily to obstetric trauma, such as vaginal tears, episiotomy, the mode of repair and damage to the pelvic floor muscles as probable causes for PD. These studies did not refer to estrogen deficiency and the possible effect of breastfeeding on vaginal atrophy and its contribution to PD. Comparison between vaginal deliveries and cesarean sections revealed that there is no difference in the prevalence of PD between the two groups, and according to these findings it can be assumed that the mechanical trauma to the vagina and pelvic floor during delivery is not the main cause for the development of PD.

Vaginal atrophy due to estrogen deficiency is a common cause for postmenopausal dyspareunia. With estrogen deficiency, profound changes occur in the vagina: vaginal mucosa becomes thin and pale or hyperemic and loose her flexibility. Blood flow decreases, normal vaginal discharge is reduced, and maturation of epithelial cells do not take place in the absence of estrogen. Women with estrogen deficiency may complain of dryness, pruritus, irritation, burning, dysuria, pain and dyspareunia. These changes are reversible by estrogen, given systemically or topically, and cause resolution of clinical findings, as well as disappearance of symptoms in several weeks.

Similar to postmenopausal patients, breastfeeding women immediately after delivery, experience decline of estrogen levels, and this decline may persist as long as lactation is continued. Therefore, many women a

Detailed Summary:
Sponsor: Meir Medical Center

Current Primary Outcome: Prevalence of vulvovaginal atrophy among puerperal women [ Time Frame: one year ]

Prevalence of vulvovaginal atrophy due to estrogen deficiency among puerperal women, according to cytological parameters.


Original Primary Outcome: Same as current

Current Secondary Outcome:

  • Prevalence of dyspareunia among women with puerperal vaginal atrophy. [ Time Frame: one year ]
    Prevalence and cause of dyspareunia among puerperal women with and without vaginal atrophy will be assesed
  • Effect of treatment with topical estrogen on dyspareunia. [ Time Frame: 2 months from begining of treatment ]
    The effect of vaginal estrogen cream on the prevalence of atrophy, its effect on postpartum dyspareunia and side effects.


Original Secondary Outcome: Same as current

Information By: Meir Medical Center

Dates:
Date Received: March 20, 2011
Date Started: March 2011
Date Completion:
Last Updated: April 7, 2015
Last Verified: April 2012