Do Iranian Women with Endometriosis Suffer from Sexual Dysfunction?

Impact of endometriosis on female sexual function: an updated systematic review and meta-analysis

Introduction

Endometriosis can lead to a state of chronic inflammation marked by the presence of scarring and adhesions within the pelvis and/or other parts of the body. Recent estimates suggest that globally this condition affects approximately 10% of women in the reproductive age group.

Aims

In this study we sought updated evidence on the association between endometriosis and sexual function in female patients.

Methods

We used standard assessment tools to conduct a systematic search of the PubMed, EMBASE, and Scopus databases for observational studies that documented the association of endometriosis with female sexual function. A random-effects model was used for the analysis, and effect sizes were reported as the weighted mean difference (WMD) or OR with 95% CIs.

Results

A total of 13 studies were selected for inclusion in our investigation. All of the included studies were cross-sectional in design. The data on sexual function in most of the studies were collected by using the Female Sexual Function Index (FSFI) tool, for which higher scores suggest better sexual function. The risk of sexual dysfunction (based on specific cutoffs for the FSFI score) was higher in women with than in women without endometriosis (OR 1.71; 95% CI, 1.21-2.43). In addition, when we used continuous scores to examine the risk of sexual dysfunction, diagnosis of endometriosis was associated with significantly lower overall FSFI scores (WMD, -3.40; 95% CI, -5.13 to -1.66) and lower scores on all of its 6 domains, ie, desire (WMD, -0.27; 95% CI, -0.53 to -0.02), arousal (WMD, -0.43; 95% CI, -0.79 to -0.07), lubrication (WMD, -0.49; 95% CI, -0.66 to -0.31), orgasm (WMD, -0.65; 95% CI, -1.07 to -0.23), satisfaction (WMD, -0.52; 95% CI, -0.77 to -0.26), and pain (WMD, -1.06; 95% CI, -1.57 to -0.55).

Conclusion

The findings of this study suggest that female patients with endometriosis have suboptimal sexual function compared with healthy female subjects. Patients with endometriosis should be offered sexual counseling and supportive care by a multidisciplinary team of gynecologists, psychologists, and sexual therapists.

Endometriosis decreases female sexual function and increases pain severity: a meta-analysis

PURPOSE

This study aimed to explore the effects of endometriosis on female sexual function.

METHODS

PubMed, Embase, and Web of Science databases were searched to analyze the Female Sexual Function Index (FSFI) or visual analog scale (VAS) scores between women with and without endometriosis. Data from publications were generated, and the sexual function of women with and without endometriosis was systematically evaluated.

RESULTS

A total of six publications were included in the study. The FSFI total score and its six domains were significantly lower in women with endometriosis: FSFI total score (P < 0.001), desire (P = 0.045), arousal (P = 0.039), pain domains (P < 0.001), lubrication (P < 0.001), orgasm (P = 0.001), and satisfaction (P < 0.001). Women with endometriosis exhibited more severity in terms of VAS scores for dyspareunia (P = 0.008) and chronic pelvic pain (P < 0.001); however, no significant severity for dysmenorrhea was observed (P = 0.118). Subgroup analysis showed that the region was not a source of heterogeneity. Publication bias was not noted in all included studies, and most results of the sensitivity analysis for the included indexes were stable, which implied that our results were relatively reliable.

CONCLUSION

The present meta-analysis provided evidence that endometriosis decreased female sexual function and increased the pain severity of dyspareunia and chronic pelvic pain.

[Living with endometriosis, sexual experiences of patients and their partners: A French qualitative study]

AIM

Endometriosis is a disabling gynecological pathology. Couples who face it frequently encounter sexual difficulties related to dyspareunia. This study aims to understand the sexual experiences of endometriosis patients and their partners.

METHODS

A total of 13 patients and 13 partners were interviewed prior to surgery. Semi-structured interviews were conducted separately and explored their sexual experiences. The interviews were transcribed verbatim and analyzed using content analysis.

RESULTS

Both members of the couple reported pain during intercourses; decreased sexual desire; adaptation during sexual intercourses; communication about sexuality, which can be either open or a source of conflict, and the search for explanations for endometriosis. As for the emotional sphere, patients report anticipatory anxiety while partners report frustration and hope.

CONCLUSION

These couples are in difficulty regarding sexuality, it is necessary to take care of both members of the couple and to encourage communication between them.

The effect of endometriosis on sexual function as assessed with the Female Sexual Function Index: systematic review and meta-analysis

AIM

To systematically compare sexual function between non-treated women with and without endometriosis.

METHODS

A systematic review was performed on PubMed/Medline, Scopus, EMBASE, Web of Science and Cochrane Library databases searching studies that analyzed sexual function (assessed with the 19-item Female Sexual Function Index [FSFI]), and dyspareunia, chronic pelvic pain and dysmenorrhea (assessed with a visual analogue scale [VAS]) in women with and with endometriosis.

RESULTS

In 4 studies, non-treated women with endometriosis presented a higher risk of female sexual dysfunction (mean total FSFI score ≤ 26.55; OR = 2.38; 95% confidence interval [CI] = 1.12, 5.04). Although mean total FSFI scores were not significantly different between women with and without endometriosis (mean difference [MD] = -2.15; 95% CI -4.96, 0.67); all FSFI domain scores were significantly lower in women with endometriosis (n = 4 studies): desire (MD = -0.43; 95% CI -0.57, -0.19); arousal (MD = -0.66; 95% CI -1.15, -0.17); lubrication (MD = -0.41; 95% CI -0.79, -0.02); orgasm (MD = -0.40; 95% CI -0.73, -0.06); satisfaction (MD = -0.45; 95% CI -0.72, -0.18); and pain (MD = -1.03; 95% CI -1.34, -0.72). Women with endometriosis displayed differences (more severity) in terms of VAS scores (2 studies) for dyspareunia (MD = 1.88; 95% CI 0.38, 3.37) and chronic pelvic pain (MD = 2.92; 95% CI 1.26, 4.58); but not for dysmenorrhea.

CONCLUSION

Non-treated women with endometriosis displayed altered sexual function as evidenced by lower scores in all FSFI domains, and severity of dyspareunia and chronic pelvic pain.