Most patients with deep infiltrating endometriosis experience sexual dysfunction, with deep dyspareunia, or pain during intercourse, having the most significant impact, researchers found.
The study, “Female Sexual Function in Women with Suspected Deep Infiltrating Endometriosis,” was published in the Brazil Journal of Gynecology and Obstetrics.
The prevalence of endometriosis in women of reproductive age is likely from 10–20%, but it might vary as high as 50% in women with infertility and chronic pelvic pain.
Physicians can use laparoscopy — a surgical procedure in the abdomen — to classify endometriosis by its location and extension. Deep infiltrating lesions can be identified by a physical examination. However, transvaginal ultrasound and magnetic resonance imaging have also been accurate in defining the extension of the lesions.
The quality of life of patients with endometriosis has been found to be significantly impaired. Specifically, deep dyspareunia is known to significantly impact a patient’s sexual life, with its association to reduced frequency of sexual intercourse, decreased sexual desire and arousal, and fewer orgasms.
Because there is a very close relationship between endometriosis and sexual dysfunction, researchers sought to assess the quality of sexual function of women with suspected deep infiltrating endometriosis, defined as endometriosis which invades organs near the uterus, such as the bowel or the urinary bladder.
Researchers conducted an observational and prospective study that enrolled 67 patients with either suspected or diagnosed deep infiltrating endometriosis.
Patients were assessed for pain levels through a visual analog scale (VAS), features of deep infiltrating endometriosis lesions, and scores on the Female Sexual Function Index (FSFI) before treatment.
Clinical data indicated that 92.5% of patients were symptomatic, with the predominant location of the deep infiltrating lesions in the rectosigmoid colon (area between the colon and rectum) — present in 50% of patients.
Results showed that the median overall score on the FSFI was 23.4, and the majority of patients (67.2%) had a score under 26.5 — the cutoff point for sexual dysfunction.
Additionally, the presence of deep dyspareunia and rectosigmoid endometriosis lesions significantly correlated with lower FSFI scores, adjusted by bladder lesions, patients’ age and size of lesions.
“Most patients exhibited sexual dysfunction, and deep dyspareunia was the pelvic painful symptom that showed correlation with sexual dysfunction,” researchers wrote.