The study, “Negative metacognitive beliefs predict sexual distress over and above pain in women with endometriosis,” was published in the Archives of Women’s Mental Health.
Endometriosis is a chronic inflammatory disease caused by the abnormal growth of womb cells outside the uterus, estimated to affect up to 10 percent of all women of reproductive age.
The condition is usually associated with chronic pelvic pain, infertility, painful or irregular menstrual cycles (dysmenorrhea), painful bowel movements (dyschezia) and/or urination (dysuria), painful sexual intercourse (dyspareunia), mental health issues, and low quality of life.
Among women with endometriosis, chronic pain and painful sexual intercourse are major contributors to sexual dysfunction, which includes less sexual desire and/or lubrication, arousal difficulties, and orgasm disorders.
However, very few studies focused on evaluating sexual distress, defined as negative feelings toward sexual life, including worry, anger, guilt, frustration, and dissatisfaction, in these women.
In this study, researchers set out to explore whether painful sexual intercourse, general chronic pain, and negative beliefs could be good predictors of sexual distress in a group of women with endometriosis.
The cross-sectional study enrolled 96 women between the ages of 22 and 51 with a confirmed diagnosis of endometriosis.
Demographic and clinical data were gathered through structured surveys. Negative beliefs were assessed by the Metacognitions Questionnaire and sexual distress were assessed by the Female Sexual Distress Scale-R. Chronic pain intensity was measured with a numeric rating scale.
Most women reported experiencing generalized chronic pain (81%), painful sexual intercourse (66%), and sexual distress (76%) in the three months leading up to the study.
Correlation analysis revealed that negative beliefs, but not chronic pain nor painful sexual intercourse, were good predictors of sexual distress in women with endometriosis.
“Our findings showed that dyspareunia and chronic pain have no impact on sexual distress in this population. This means that women who reported sexual distress did not differ from women who did not report sexual distress as regards to dyspareunia and chronic pain,” the researchers wrote.
“We can conclude that sexual health is not merely the absence of pain during sexual intercourse. Women with sexual distress, even if not reporting dyspareunia or chronic pain, should be kept into account for sexual health enhancement,” they added. “Treatments should not be limited to the improvement of sexual functioning but include psychological and cognitive focus. Metacognitive therapy may be beneficial for women with sexual distress related to endometriosis.”