Examining the relationships among dyspareunia, sexual distress, sexual quality of life, and marital adjustment in postpartum women

The postpartum period is a critical transition during which women may experience a range of physical, psychological, and sexual health problems. Dyspareunia is one of the most common postpartum sexual complaints and may adversely affect women’s sexual well-being, quality of life, and intimate partner relationships. This study aimed to examine the relationships among postpartum dyspareunia, sexual distress, sexual quality of life, and marital adjustment in postpartum women. This descriptive cross-sectional study was conducted with 324 postpartum women who attended the gynecology outpatient clinic of a university hospital between February and December 2023. Data were collected using a Participant Information Form, the Female Sexual Distress Scale (FSDS), the Carol Postpartum Sexual Function and Dyspareunia Assessment Scale, the Sexual Quality of Life Scale-Female (SQOL-F), and the Revised Dyadic Adjustment Scale (RDAS). Descriptive statistics, Mann–Whitney U, Kruskal–Wallis, and Spearman correlation analyses were used. Statistical significance was set at p < 0.05. Among the participants, 44.4% had moderate libido disorder and 19.8% had moderate lubrication impairment. In addition, 8.6% reported severe discomfort or pain when touching the vulva, 18.5% reported moderate pain during penetration, 18.5% reported moderate pain during vaginal intercourse, and 12.3% reported moderate pain after vaginal intercourse. Based on the FSDS cut-off score, 34.6% of women had clinically relevant sexual distress (FSDS ≥ 11.5). Women with lower sexual distress (FSDS < 11.5) had significantly higher marital adjustment and sexual quality of life scores than women with FSDS ≥ 11.5 ( p < 0.001 for both). Spearman correlation analysis demonstrated a moderate positive correlation between sexual quality of life and marital adjustment ( r = 0.565, p < 0.001), whereas sexual distress was moderately and negatively correlated with marital adjustment ( r = − 0.477, p < 0.001). Dyspareunia-related pain domains were also negatively associated with sexual quality of life and marital adjustment. Postpartum dyspareunia and sexual distress were associated with poorer sexual quality of life and lower marital adjustment. These findings indicate that postpartum sexual problems extend beyond physical discomfort and are also related to women’s sexual and relationship well-being. Routine postpartum care should therefore include assessment of sexual health, dyspareunia, sexual distress, and couple-related concerns, together with appropriate counseling and referral when necessary.