Does Endometriosis Affect Sexual Activity and Satisfaction of the Man Partner? A Comparison of Partners From Women Diagnosed With Endometriosis and Controls

Abstract

Background Endometriosis-associated pain and dyspareunia influence female sexuality, but little is known about men's experiences in affected couples. Aim To investigate how men partners experience sexuality in partnership with women with endometriosis. Methods A multi-center case-control study was performed between 2010 and 2015 in Switzerland, Germany, and Austria. 236 Partners of endometriosis patients and 236 partners of age-matched control women without endometriosis with a similar ethnic background were asked to answer selected, relevant questions of the Brief Index of Sexual Functioning and the Global Sexual Functioning questionnaire, as well as some investigator-derived questions. Outcomes We sought to evaluate sexual satisfaction of men partners of endometriosis patients, investigate differences in sexual activities between men partners of women with and without endometriosis, and identify options to improve partnership sexuality in couples affected by endometriosis. Results Many partners of endometriosis patients reported changes in sexuality (75%). A majority of both groups was (very) satisfied with their sexual relationship (73.8% vs 58.1%, P = .002). Nevertheless, more partners of women diagnosed with endometriosis were not satisfied (P = .002) and their sexual problems more strongly interfered with relationship happiness (P = .001) than in partners of control women. Frequencies of sexual intercourse (P < .001) and all other partnered sexual activities (oral sex, petting) were significantly higher in the control group. The wish for an increased frequency of sexual activity (P = .387) and sexual desire (P = .919) did not differ statistically between both groups. Clinical Translation There is a need to evaluate qualitative factors that influence sexual satisfaction in endometriosis patients. Conclusions This is one of the first studies to investigate male sexuality affected by endometriosis. The meticulous verification of diagnosis and disease stage according to operation reports and histology allows for a high reliability of diagnosis. Our men's response rate of almost 50% is higher compared to other studies. Recruiting men through their woman partner may have caused selection bias. The adjustment to the specific situation in endometriosis by selecting questions from the Brief Index of Sexual Functioning and Global Sexual Functioning and adding investigator-derived questions likely influenced the validity of the questionnaires. Despite the fact that both partners of endometriosis patients and of control women largely reported high sexual satisfaction, there are challenges for some couples that arise in the context of a sexual relationship when one partner has endometriosis. Challenges such as sexuality-related pain or a reduced frequency of sexual activities should be addressed by health care professionals to ameliorate any current difficulties and to prevent the development or aggravation of sexual dysfunction.

Impact of Endometriosis on Life-Course Potential: A Narrative Review

“…We identified 13 studies in women with endometriosis that address the impact of endometriosis on the personal relationships component of the life course. 34,45,62,[70][71][72][73][74][75][76][77][78][79] The category of "personal relationships" is inclusive of social and family connections as well as intimate partner relationships. Endometriosis may interfere with all types of interpersonal relationships, 34,62 but it is sexual health that has garnered the most research interest.…”

“…Studies have consistently reported impairment in sexual function in women with endometriosis that causes strain on intimate relationships. 45,62,70,72,75,79 In a multicenter Austrian and German study of 125 women with histologically confirmed endometriosis and dyspareunia, most women (78%) reported sexual distress, as measured on the Female Sexual Distress Scale, and 32% reported sexual dysfunction, as measured on the Female Sexual Function Index (FSFI). 74 Only 21% of women reported neither sexual distress nor sexual dysfunction.…”

Satisfaction with medical support in women with endometriosis

“…Endometriosis is an oestrogen-dependent, chronic inflammatory condition, affecting between 5 and 10% of women in their reproductive years [1,2]. The symptoms of endometriosis include dysmenorrhea, dyspareunia, non-menstrual pelvic pain, dyschesia, dys-uria, musculoskeletal pain, fatigue and infertility [3–7]. Therefore, endometriosis affects women’s quality of life [1,8,9] and often leads to psychological strain [9].…”

Partners matter: The psychosocial well-being of couples when dealing with endometriosis

“…Accordingly, there are many studies reporting impaired sexuality in women suffering from endometriosis [ 10 – 12 ] and subsequent important implications for quality of life in women [ 13 , 14 ]. Regarding the male perspective, there are two quantitative studies comparing sexual functioning of male partners of endometriosis patients to control couples [ 15 , 16 ], with diverging results regarding the increase of sexual dissatisfaction in male partners.…”