Women with deep infiltrating endometriosis (DIE) often have impaired sexual function and a lower quality of life, Italian researchers have found.
Endometriosis occurs when tissue from the uterine lining (the endometrium) grows outside the uterus. These growths might be found on the ovaries, fallopian tubes, bladder, ureters, intestines, or rectum, among other areas. Chronic pelvic pain is a common symptom of endometriosis, which is estimated to affect over 170 million women worldwide.
DIE occurs when endometriosis penetrates over 5 mm into the peritoneum, the membrane that lines the abdominal cavity. About 20% of women with endometriosis are thought to have DIE.
To learn more about how DIE affects sexual activity, the researchers enrolled 182 women in a cross-sectional study. The women had preoperative diagnoses of DIE confirmed by pelvic exams and, if necessary, other diagnostic tests.
Each woman anonymously completed two questionnaires. The Sexual Health Outcomes in Women Questionnaire (SHOW-Q) was used to assess sexual satisfaction, orgasm, desire, and any pelvic problem interference in the last four weeks. Another questionnaire, the Short Form 36 (SF-36), assessed each woman’s quality of life.
The researchers also used a visual analog scale to evaluate pain symptoms associated with DIE, including menstrual pain, pain with urination or bowel movements, chronic pelvic pain, and painful intercourse.
Almost 62% of the participants said they had a low frequency of intercourse. About 71% said that their pelvic issues “substantially” impaired sexual activity.
Overall, the women’s SHOW-Q scores indicated poor sexual functioning. Satisfaction and orgasm were the two most commonly affected areas, but problems were found in all domains. “It seems therefore that all aspects of sexual life are equally impaired in women with DIE,” the authors wrote.
They added, “These data may confirm the complexity of this disease, which causes not only painful symptoms but also an overall impairment of different aspects of sexuality.”
There appeared to be a correlation between DIE and quality of life. Many aspects of day-to-day life, in addition to sex, can be affected by endometriosis, such as work, hobbies, and socializing. Chronic pain may make women irritable and reclusive.
The researchers also found that women with severe dyspareunia (painful intercourse) had more problems with orgasm, satisfaction, and desire when compared to women who reported light/moderate dyspareunia.
Endometriotic lesions in the vagina seemed to cause more sexual problems than lesions found elsewhere, possibly because this area is more stimulated during intercourse.
The researchers encouraged help with sexual and mental health issues for women with endometriosis.
“We believe that the attention directed toward women with endometriosis must be focused not only on the disease itself but also on the women as a whole,” they wrote.
The study was published online in April in The Journal of Sexual Medicine.
Resources
The American College of Obstetricians and Gynecologists
“Endometriosis”
(October 2012)
http://www.acog.org/~/media/For%20Patients/faq013.pdf?dmc=1&ts=20130505T1356334485
The Journal of Sexual Medicine
Montanari, Giulia, MD, et al.
“Women with Deep Infiltrating Endometriosis: Sexual Satisfaction, Desire, Orgasm, and Pelvic Problem Interference with Sex”
(Full-text. First published online: April 3, 2013)
http://onlinelibrary.wiley.com/doi/10.1111/jsm.12133/abstract