Evaluation of sexual function in women with deep infiltrating endometriosis

Sex Reprod Healthc. 2018 Jun;16:6-9. doi: 10.1016/j.srhc.2017.12.005. Epub 2018 Jan 3.


Introduction: The influence of deep infiltrating endometriosis (DIE) on sexual function has been poorly studied. The aim of this study was to evaluate the impact of DIE on sexual function by administering questionnaires to women.

Methods: Women with a clinical and ultrasound diagnosis of DIE and histological confirmation of endometriosis were included in the study. In interview, women were asked to rate five pain symptoms, dysmenorrhea, dyspareunia, dyschezia, dysuria and Cronic Pelvic Pain (CPP), on a visual analogue scale (VAS), and sexual function was assessed using the Female Sexual Function Index (FSFI).

Results: A total of 170 women with DIE were identified. A VAS score of 7 or more was taken to indicate that a symptom was 'severe'. Dysmenorrhea was reported to be severe by 66.5% of the sample, dyspareunia by 41.8%, dyschezia by 32.4% and dysuria by 6.5%. Mean FSFI scores did not differ significantly between women with and without endometriosis lesions at particular sites, except for rectovaginal nodules, which were found to be associated with more impaired sexual activity and sexual function.

Conclusions: Women with DIE had significant impairment of sexual activity when a partial or total infiltration of the rectovaginal septum occurred. Particular attention should be given to women with this kind of lesion.

Keywords: Deep infiltrating endometriosis (DIE); Female Sexual Function Index (FSFI); Sexual activity; Sexual function; Visual analogue scale (VAS).

MeSH terms

  • Adult
  • Dysmenorrhea / etiology*
  • Dyspareunia / etiology*
  • Endometriosis / complications*
  • Endometriosis / pathology
  • Female
  • Humans
  • Pelvic Pain / etiology*
  • Rectum / pathology
  • Severity of Illness Index
  • Sexual Behavior*
  • Sexual Dysfunction, Physiological / etiology*
  • Surveys and Questionnaires
  • Vagina / pathology