L26/P-319 Postpartum Sexual Dysfunction and Impaired Quality of Life After Childbirth in Women with Deep Infiltrating Endometriosis

Abstract Study question Is postpartum sexual dysfunction prevalent in women with deep infiltrating endometriosis, and is it influenced by mode of delivery, obstetric trauma, or lesion location? Summary answer Postpartum sexual dysfunction is highly prevalent and persistent in women with deep endometriosis and is not significantly influenced by delivery mode or minor obstetric trauma. What is known already Sexual dysfunction is common in women with endometriosis, particularly in those with deep infiltrating disease, and often persists despite surgical treatment. Pregnancy may temporarily alleviate endometriosis-related symptoms, but pain and sexual dysfunction frequently recur postpartum. In the general obstetric population, postpartum sexual dysfunction is common, while mode of delivery appears to have little influence. Women with endometriosis are at increased risk of obstetric complications; however, data on postpartum quality of life and sexual function in this population, and the potential impact of delivery-related factors, remain scarce. Study design, size, duration This prospective cohort study included 56 women with surgically confirmed deep infiltrating endometriosis who delivered a singleton pregnancy and were followed for 12 months postpartum. Participants/materials, setting, methods Participants were recruited at a tertiary university hospital. Quality of life and sexual function were assessed at 6 and 12 months postpartum using the Endometriosis Health Profile-30 with the additional sexual domain. Sexual dysfunction was defined as any impairment in the sexual relationship domain. Outcomes were compared by mode of delivery, obstetric perineal trauma, and endometriosis lesion location using non-parametric statistical tests with correction for multiple testing. Main results and the role of chance Overall impairment in quality of life was common, affecting 80.0% of women at 6 months and 83.3% at 12 months postpartum. Postpartum sexual dysfunction was highly prevalent, reported by 71.9% of women at 6 months and 59.5% at 12 months. Among affected women, median sexual relationship scores indicated persistent impairment at both time points. No significant differences in sexual dysfunction or overall quality of life were observed according to mode of delivery (vaginal vs caesarean section) or presence of minor obstetric perineal trauma. Exploratory analyses suggested a higher prevalence of sexual dysfunction at 12 months postpartum in women with rectovaginal and/or rectal involvement without uterosacral disease; however, this association did not remain statistically significant after correction for multiple comparisons. Overall, chance is unlikely to explain the consistently high prevalence of postpartum sexual dysfunction observed across subgroups, but small sample sizes limit the detection of modest effects. Limitations, reasons for caution The modest sample size limited statistical power for subgroup analyses. Lack of pre-pregnancy sexual function data and unmeasured confounders such as breastfeeding, hormonal treatment, and psychosocial factors may have influenced results. Wider implications of the findings Our results show no differences in postpartum QoL and sexual function between delivery modes in women with DIE. Thus, delivery mode should not be chosen with the aim of preventing sexual dysfunction in women with DIE. Postpartum care should focus on endometriosis-related factors and targeted interventions to support sexual health. Trial registration number No