{"paper_id":"635510f4-8671-42b7-8bb9-efa0c9af669c","body_text":"Fertility Gynecology Andrology . 2021 December; 1(1):e122388.\nPublished online 2022 March 7.\ndoi: 10.5812/fga.122388.\nLetter\nComparison of Sexual Distress and Quality of Life in Women with\nEndometriosis Before and After Laparoscopy\nMalihe Fakehi 1, Fatemeh Davari Tanha2, Neda Reihani 2 and Marjan Ghaemi\n 3, *\n1Shahid Akbarabadi Hospital, Iran University of Medical Sciences, Tehran, Iran\n2Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran\n3Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran\n*Corresponding author: Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran. Email: marjan_ghaemi@yahoo.com\nReceived 2022 January 04; Revised 2022 February 22; Accepted 2022 February 22.\nKeywords: Quality of Life, Sexual Function, Endometriosis\nDear Editor,\nEndometriosis is one of the most common diseases in\nwomen of reproductive age. This disease is the endome-\ntrial tissue space outside the uterine cavity that responds\nto steroid hormones in monthly cycles (1). Endometrio-\nsis can cause adhesions, local inflammation, dysmenor-\nrhea, dyspareunia, chronic pelvic pain, and infertility (2).\nDyspareunia is one of the most common complaints of\nthese patients that is superficial (pain at the entrance to\nthe vagina) or deep (deep pain during deep intercourse)\n(3). Dyspareunia affects the sexual life of patients by de-\ncreased intimacy , libido, and sexual arousal (4).\nIn previous studies, surgical interventions in en-\ndometriosis have improved dyspareunia and the sexual\nquality of life; nevertheless, the improvement of sexual\nfunction, and not only the reduction of pain at inter-\ncourse, should be considered the primary clinical goal of\nendometriosis treatment (5).\nThis cohort study was conducted on married female\nsubjects of reproductive age with endometriosis who were\ncandidates for laparoscopy in an academic center affiliated\nwith Tehran University of Medical Sciences, Tehran, Iran,\nwithin January 2019 to March 2020. The sexual quality of\nlife was measured before and 3 months after the interven-\ntion. The exclusion criteria were the lack of definitive proof\nof endometriosis, pain with a source other than the dis-\nease, and history of pelvic surgery or pelvic mass other\nthan endometriosis.\nThe questionnaires used in this study included the fe-\nmale sexual function index (FSFI), Female Sexual Distress\nScale, and Numeric Analog Scales (NAS) that assessed the\npain felt by the patient within a range of 0 - 10 points. To-\ntally , 69 married female subjects entered the study . Table 1\nshows the demographic characteristics of the participants.\nTable 1. Demographic Characteristics of the Participants a\nCharacteristics Values\nAge (y) 29.04 ± 4.6\nBody mass index (kg/m2) 27.73 ± 2.3\nMenarche (y) 12.54 ± 1.3\nParity 0.5 ± 0.6\na Values are expressed as mean ± SD.\nDysmenorrhea, persistent pelvic pain, and pain during\ndefecation were observed in 88, 34, and 29% of the patients.\nIn addition, dyspareunia, infertility , and fear of intimacy\nwere noticed in 62, 58, and 23.2% of the participants. The\nduration of infertility in the affected couples was at least 1\nyear and maximum 11 years.\nThe estimated mean values of sexual stress before and\nafter the surgery were 45.38 ± 5.2 and 20.37 ± 1.3, respec-\ntively . The mean values of pain scores during sex before\nand after the intervention were 6.46 ± 3.2 and 3.0 ± 1.6,\nrespectively . The FSFI mean scores before and after the\nsurgery were 31.6 ± 5.1 and 71.5 ± 2.8, respectively , con-\nfirming that sexual satisfaction and performance indica-\ntors have significantly improved after the surgery with less\npain, more desire and arousal, and more lubrication and\nsatisfaction.\nAs previously mentioned, sexual function in women is\na multifactorial process that includes psychological and\nsexual dimensions (5). Furthermore, women might show\ndifferent reactions to dyspareunia, such as sex avoidance,\ndealing with the pain during sex to keep sexual intimacy ,\nor fear of pregnancy (6), which have a devastating effect on\nCopyright © 2021, Fertility , Gynecology and Andrology . This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0\nInternational License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the\noriginal work is properly cited.\n\nFakehi M et al.\ntheir quality of life.\nIn conclusion, numerous young women with en-\ndometriosis experience dyspareunia that surgery can im-\nprove. In the treatment of such patients, it seems that a\nmultidisciplinary team consisting of gynecologists, sexol-\nogists, and psychologists can play a better role in the im-\nprovement of their quality of life.\nFootnotes\nConflict of Interests: It was not declared by the authors.\nFunding/Support: It was not declared by the authors.\nReferences\n1. Parasar P, Ozcan P, Terry KL. Endometriosis: Epidemiology , Diagno-\nsis and Clinical Management. Curr Obstet Gynecol Rep. 2017;6(1):34–41.\ndoi: 10.1007/s13669-017-0187-1. [PubMed: 29276652]. [PubMed Central:\nPMC5737931].\n2. Kor E, Mostafavi SRS, Mazhin ZA, Dadkhah A, Kor A, Arvanagh SH,\net al. Relationship between the severity of endometriosis symp-\ntoms (dyspareunia, dysmenorrhea and chronic pelvic pain) and the\nspread of the disease on ultrasound. BMC Res Notes . 2020; 13(1):546.\ndoi: 10.1186/s13104-020-05388-5. [PubMed: 33239095]. [PubMed Cen-\ntral: PMC7687799].\n3. Tayyeb M, Gupta V. Dyspareunia. StatPearls. Florida, USA; 2022.\n4. Ambler DR, Bieber EJ, Diamond MP. Sexual function in elderly women:\na review of current literature. Rev Obstet Gynecol . 2012; 5(1):16–27.\n[PubMed: 22582123]. [PubMed Central: PMC3349920].\n5. Barbara G, Facchin F, Meschia M, Berlanda N, Frattaruolo MP, Ver-\ncellin IP. When love hurts. A systematic review on the effects of sur-\ngical and pharmacological treatments for endometriosis on female\nsexual functioning. Acta Obstet Gynecol Scand. 2017;96(6):668–87. doi:\n10.1111/aogs.13031. [PubMed: 27687240].\n6. Denny E, Mann CH. Endometriosis-associated dyspareunia: the im-\npact on women’s lives. J Fam Plann Reprod Health Care. 2007;33(3):189–\n93. doi: 10.1783/147118907781004831. [PubMed: 17609078].\n2 Fertility Gynecology Andrology . 2021; 1(1):e122388.","source_license":"CC0","license_restricted":false}