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

Abstract

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 ¼ 2.38; 95% confidence interval [CI] ¼ 1.12, 5.04). Although mean total FSFI scores were not significantly different between women with and without endometriosis (mean difference [MD] ¼ À2.15; 95% CI À4.96, 0.67); all FSFI domain scores were significantly lower in women with endometriosis (n ¼ 4 studies): desire (MD ¼ À0.43; 95% CI À0.57, À0.19); arousal (MD ¼ À0.66; 95% CI À1.15, À0.17); lubrication (MD ¼ À0.41; 95% CI À0.79, À0.02); orgasm (MD ¼ À0.40; 95% CI À0.73, À0.06); satisfaction (MD ¼ À0.45; 95% CI À0.72, À0.18); and pain (MD ¼ À1.03; 95% CI À1.34, À0.72). Women with endometriosis displayed differences (more severity) in terms of VAS scores (2 studies) for dyspareunia (MD ¼ 1.88; 95% CI 0.38, 3.37) and chronic pelvic pain (MD ¼ 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.

Quality of intimate relationships, dyadic coping, and psychological health in women with endometriosis: Results from an online survey

“…Intimate relationships are also affected, considering not only the association between endometriosis and infertility (which involves revising the couple's expectations and future plans, including having children), but also its negative consequences on social and working lives, intimacy and sexuality [9]. In this regard, there is evidence that endometriosis-related dyspareunia (i.e., pain at intercourse) is an important cause of sexual dysfunction [10][11][12], which may lead to reduced or even non-existent sexual activity, with negative consequences on women's self-esteem and intimate relationships [13,14]. In a study by De Graaff et al [15], 468 women (50% of the total) reported that endometriosis affected their relationships.…”

Sexual function in patients with endometriosis: a prospective case–control study in China

“…This suggests that clinicians and nurses need to take active measures to improve the quality of sexual life of patients with endometriosis. 21 Radical laparoscopic excision of endometriosis offers an effective treatment option and leads to a significant improvement in dyspareunia and quality of sexual life. 22 Buggio et al 23 discussed the importance of integrating psychological interventions (including psychotherapy) and sexual therapy in treatment of endometriosis.…”

Correlates of Sexual Function in a Sample of Spanish Women with Endometriosis

“…Despite endometriosis being a benign gynaecological disease, it can affect female sexual function to a certain extent. This suggests that clinicians and nurses need to take active measures to improve the quality of sexual life of patients with endometriosis [ 47 ].…”

“…This issue was addressed in a recent metanalysis in which higher rates of dyspareunia in women with endometriosis did not predict sexual distress, and metacognitive beliefs were more influential on sexual distress than pain [ 47 ]. Exploratory hierarchical regression analyses revealed that for women, age and relationship satisfaction (both treated as covariates), as well as depression, emerged as statistically significant correlates of sexual function (i.e., women who were older and reported greater levels of depression and less satisfaction with their current relationship indicated poorer sexual functioning).…”