Postpartum health-seeking behaviours, awareness and experiences of Genitourinary Syndrome of Lactation.

INTRODUCTION

The hypo-oestrogenic state of the postpartum period leads to bothersome genitourinary symptoms in some lactating women. These symptoms have been named 'Genitourinary Syndrome of Lactation' (GSL), and include vaginal dryness, atrophy, urinary incontinence (UI), urinary tract infection (UTI), delayed wound healing and dyspareunia. Despite its prevalence, the experiences, awareness, quality of life, treatments offered and health-seeking behaviours of mothers with GSL in Australia are unknown.

METHODS

A national cross-sectional survey was conducted in Australia, assessing health-seeking behaviours, healthcare provider discussion (provider or patient-initiated), type of healthcare provider, and treatments offered. Quality of life (QoL) was assessed using sliding scales (0-100) to determine the significance of impact across domains.

RESULTS

One hundred and thirteen Australian women, aged 22-48 years responded (mean 33.9). Findings indicated 37% of women were aware of GSL, leaving almost two-thirds unaware. Sixty three percent (n = 65) of women reported at least one genitourinary symptom, with vaginal dryness (57%), urinary incontinence (UI) (27%) and dyspareunia (36%) the most prevalent. Furthermore, one in five respondents reported a healthcare provider-initiated discussion; in contrast, one-third (33%) of respondents reported initiating the discussion. Of respondents, twenty-eight per cent (n = 29) reported being offered treatment, with the primary barrier to treatment (32%) lack of treatment awareness. GSL had a moderate to severe impact on quality of life across the following domains: sexual activity (43%), daily activity (25%), mental health (anxiety, stress, and frustration) (25%) and caring for baby (7%).

CONCLUSION

A significant proportion of breastfeeding women had GSL symptoms, but many were unaware of the condition. Screening, awareness, and referrals must be enhanced in primary care settings to improve diagnosis, management and minimise barriers to treatment.