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Endometriosis decreases female sexual function and increases pain severity: a meta-analysis

  • General Gynecology
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Abstract

Purpose

This study aimed to explore the effects of endometriosis on female sexual function.

Methods

PubMed, Embase, and Web of Science databases were searched to analyze the Female Sexual Function Index (FSFI) or visual analog scale (VAS) scores between women with and without endometriosis. Data from publications were generated, and the sexual function of women with and without endometriosis was systematically evaluated.

Results

A total of six publications were included in the study. The FSFI total score and its six domains were significantly lower in women with endometriosis: FSFI total score (P < 0.001), desire (P = 0.045), arousal (P = 0.039), pain domains (P < 0.001), lubrication (P < 0.001), orgasm (P = 0.001), and satisfaction (P < 0.001). Women with endometriosis exhibited more severity in terms of VAS scores for dyspareunia (P = 0.008) and chronic pelvic pain (P < 0.001); however, no significant severity for dysmenorrhea was observed (P = 0.118). Subgroup analysis showed that the region was not a source of heterogeneity. Publication bias was not noted in all included studies, and most results of the sensitivity analysis for the included indexes were stable, which implied that our results were relatively reliable.

Conclusion

The present meta-analysis provided evidence that endometriosis decreased female sexual function and increased the pain severity of dyspareunia and chronic pelvic pain.

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References

  1. Chapron C et al (2019) Rethinking mechanisms, diagnosis and management of endometriosis. Nat Rev Endocrinol 15(11):666–682

    Article  Google Scholar 

  2. Mińko A et al (2021) Endometriosis-a multifaceted problem of a modern woman. Int J Env Res Public Health 18(15):8177

    Article  Google Scholar 

  3. Shafrir AL et al (2018) Risk for and consequences of endometriosis: a critical epidemiologic review. Best Pract Res Clin Obstet Gynaecol 51:1–15

    Article  CAS  Google Scholar 

  4. Kalaitzopoulos DR et al (2020) Association between endometriosis and gynecological cancers: a critical review of the literature. Arch Gynecol Obstet 301(2):355–367

    Article  Google Scholar 

  5. Kvaskoff M et al (2021) Endometriosis and cancer: a systematic review and meta-analysis. Hum Reprod Update 27(2):393–420

    Article  CAS  Google Scholar 

  6. García-Peñarrubia P et al (2020) Hypothetical roadmap towards endometriosis: prenatal endocrine-disrupting chemical pollutant exposure, anogenital distance, gut-genital microbiota and subclinical infections. Hum Reprod Update 26(2):214–246

    Article  Google Scholar 

  7. Culley L et al (2013) The social and psychological impact of endometriosis on women’s lives: a critical narrative review. Hum Reprod Update 19(6):625–639

    Article  Google Scholar 

  8. Della Corte L et al (2020) The burden of endometriosis on women’s lifespan: a narrative overview on quality of life and psychosocial wellbeing. Int J Env Res Public Health 17(13):4683

    Article  Google Scholar 

  9. Ni L et al (2021) Bioinformatic analysis of key pathways and genes shared between endometriosis and ovarian cancer. Arch Gynecol Obstet. https://doi.org/10.1007/s00404-021-06285-3

    Article  Google Scholar 

  10. Laganà AS et al (2017) Anxiety and depression in patients with endometriosis: impact and management challenges. Int J Womens Health 9:323–330

    Article  Google Scholar 

  11. Lukic A et al (2016) Quality of sex life in endometriosis patients with deep dyspareunia before and after laparoscopic treatment. Arch Gynecol Obstet 293(3):583–590

    Article  CAS  Google Scholar 

  12. Flynn KE et al (2016) Sexual satisfaction and the importance of sexual health to quality of life throughout the life course of US adults. J Sex Med 13(11):1642–1650

    Article  Google Scholar 

  13. Bastu E et al (2020) Improvement in quality of life and pain scores after laparoscopic management of deep endometriosis: a retrospective cohort study. Arch Gynecol Obstet 302(1):165–172

    Article  Google Scholar 

  14. Baser RE, Li Y, Carter J (2012) Psychometric validation of the female sexual function index (FSFI) in cancer survivors. Cancer 118(18):4606–4618

    Article  Google Scholar 

  15. Sand M et al (2009) The female sexual function index (FSFI): a potential “gold standard” measure for assessing therapeutically-induced change in female sexual function. Fertil Steril 92(3):S129

    Article  Google Scholar 

  16. Chen I et al (2020) Pre-and postsurgical medical therapy for endometriosis surgery. Cochrane Database Syst Rev 11(11):Cd003678

    Google Scholar 

  17. De Graaff AA et al (2016) Dyspareunia and depressive symptoms are associated with impaired sexual functioning in women with endometriosis, whereas sexual functioning in their male partners is not affected. Hum Reprod 31(11):2577–2586

    Article  Google Scholar 

  18. Evangelista A et al (2014) Sexual function in patients with deep infiltrating endometriosis. J Sex Med 11(1):140–145

    Article  Google Scholar 

  19. Ghajarzadeh M et al (2014) Do iranian women with endometriosis suffer from sexual dysfunction? Sex Disabil 32(2):189–195

    Article  Google Scholar 

  20. Melis I et al (2015) Sexual function in women with deep endometriosis: correlation with quality of life, intensity of pain, depression, anxiety, and body image. Int J Sex Health 27(2):175–185

    Article  Google Scholar 

  21. Somigliana E et al (2020) Natural pregnancy seeking in subfertile women with endometriosis. Reprod Sci 27(1):389–394

    Article  Google Scholar 

  22. Yang X et al (2021) Sexual function in patients with endometriosis: a prospective case-control study in China. J Int Med Res 49(4):3000605211004388

    Article  Google Scholar 

  23. Lee YH (2018) An overview of meta-analysis for clinicians. Korean J Intern Med 33(2):277–283

    Article  Google Scholar 

  24. Pérez-López FR et al (2020) The effect of endometriosis on sexual function as assessed with the female sexual function Index: systematic review and meta-analysis. Gynecol Endocrinol 36(11):1015–1023

    Article  Google Scholar 

  25. Peterson J et al (2011) The Newcastle-Ottawa scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Ottawa Hospital Research Institute, Ottawa, pp 1–12

    Google Scholar 

  26. Higgins JP et al (2003) Measuring inconsistency in meta-analyses. BMJ 327(7414):557–560

    Article  Google Scholar 

  27. Egger M et al (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315(7109):629–634

    Article  CAS  Google Scholar 

  28. Bulun SE et al (2019) Endometriosis. Endocr Rev 40(4):1048–1079

    Article  Google Scholar 

  29. Marquardt RM et al (2019) Progesterone and estrogen signaling in the endometrium: what goes wrong in endometriosis? Int J Mol Sci 20(15):3822

    Article  CAS  Google Scholar 

  30. Giampaolino P et al (2020) Dioxin and endometriosis: a new possible relation based on epigenetic theory. Gynecol Endocrinol 36(4):279–284

    Article  CAS  Google Scholar 

  31. Calicchio R et al (2014) DNA methylation, an epigenetic mode of gene expression regulation in reproductive science. Curr Pharm Des 20(11):1726–1750

    Article  CAS  Google Scholar 

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, The Affiliated Huai’an No. 1 People’s Hospital of Nanjing Medical University, Huai’an, 223300, Jiangsu, People’s Republic of China

    Can Shi, Hongge Xu, Ting Zhang & Yingchun Gao

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  1. Can Shi
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  2. Hongge Xu
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  3. Ting Zhang
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  4. Yingchun Gao
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Contributions

CS and YG carried out the conception and design of the research, HX participated in the acquisition of data. TZ carried out the analysis and interpretation of data. CS participated in the design of the study and performed the statistical analysis. CS and YG conceived of the study, and participated in its design and coordination and helped to draft the manuscript and revision of manuscript for important intellectual content. All authors read and approved the final manuscript.

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Correspondence to Yingchun Gao.

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Shi, C., Xu, H., Zhang, T. et al. Endometriosis decreases female sexual function and increases pain severity: a meta-analysis. Arch Gynecol Obstet 307, 195–204 (2023). https://doi.org/10.1007/s00404-022-06478-4

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  • DOI: https://doi.org/10.1007/s00404-022-06478-4

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