Sexual dysfunction in women with endometriosis: beyond dyspareunia. a multicenter cross-sectional study

Objective To characterize the domains of sexual function and describe the prevalence and patterns of female sexual dysfunction in a multicenter Colombian cohort of women with endometriosis. Materials and methods A multicenter cross-sectional study was conducted among women aged 18–50 years with a confirmed diagnosis of endometriosis recruited from a tertiary referral hospital and a national endometriosis patient association in Colombia. Participants reported sexual activity during the preceding four weeks. Sexual function was assessed using the validated Spanish version of the Female Sexual Function Index (FSFI), and female sexual dysfunction was defined as a total FSFI score <26.55. Baseline characteristics were compared according to FSFI status, and factors associated with female sexual dysfunction were evaluated using Poisson regression with robust variance. Results A total of 166 women were included. The median total FSFI score was 20.9 (IQR, 14.7–25.1), and 81.3% met the criterion for female sexual dysfunction. The lowest median scores were observed in sexual desire (2.4; IQR, 1.8–3.6) and pain/dyspareunia (2.4; IQR, 1.6–3.6), with additional impairment in arousal, lubrication, and orgasm. Women with female sexual dysfunction were more frequently represented in lower socioeconomic strata (p = 0.028). No independent associations were identified in the adjusted Poisson regression analysis. Conclusions Female sexual dysfunction was frequently observed in this multicenter Colombian cohort and involved multiple domains of sexual function beyond dyspareunia. Routine assessment of sexual function should be incorporated into comprehensive endometriosis care, while future prospective studies are needed to better understand the determinants of sexual dysfunction.