Effects of sensate focus technique and position changing on sexual function of women with deep-infiltrating endometriosis after surgery: A clinical trial study

Parisa Tajik, Shadab Shahali, Roya Padmehr
International journal of reproductive biomedicine · 2023 · vol. 21(6) , pp. 509–520 · doi:10.18502/ijrm.v21i6.13638 · PMID:37560067 · PMC10407917 · W4385211386
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Sensate focus technique and sexual position changing significantly improved sexual function and reduced sexual pain in women with deep-infiltrating endometriosis after surgery.

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This parallel non-blinded randomized clinical trial studied 80 women (final analyzed n=76) with deep-infiltrating endometriosis who were 3–6 months after laparoscopic excision and not using hormonal medication, comparing an intervention of couple-based sensate focus training (via virtual 2-hour session plus weekly researcher follow-up) and sexual position changes against usual care. Sexual function was measured with the Female Sexual Function Index (FSFI) across desire, arousal, lubrication, orgasm, satisfaction, and sexual pain, with pain also assessed by a visual analog scale (VAS); the study explicitly notes exclusion for pregnancy and includes an education-only approach during the COVID-19 pandemic. The intervention group had significantly higher total FSFI scores at 1 and 2 months than controls, alongside significant differences in sexual pain VAS across follow-up periods, although the control group’s pain scores were not significantly different at 1 and 2 months. This paper is centrally about endometriosis — it evaluates whether sensate focus technique and changing sexual positions improve sexual function and sexual pain after surgery in women with deep-infiltrating endometriosis.

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Abstract

BACKGROUND: Endometriosis is a disease that affects women throughout their sexual life. Sexual health is, therefore, a major concern for these women. OBJECTIVE: This study aimed to assess the effects of the sensate focus technique and position changing on the sexual function of women with deep-infiltrating endometriosis 3-6 months after surgery. MATERIALS AND METHODS: This clinical trial study was performed on 80 women with deep endometriosis, aged 18-45 yr, who were referred to the endometriosis clinic of Avicenna fertility center, Tehran, Iran for follow-up after surgery from January to September 2021. They were divided randomly into 2 groups. In the intervention group, 2-hr virtual training sessions were held and the control group only completed the questionnaires without any intervention. Sexual function was evaluated after 4 and 8 wk. RESULTS: 8 wk after the intervention, the mean score of sexual function in the intervention group was significantly improved (p < 0.001). The mean total score of sexual function in the pre-intervention period reached from 24.16 to 28.31 in 4 wk after the intervention and 29.85, 8 wk after the intervention. The mean score of sexual pain during the follow-up periods was significantly improved in the intervention group (p < 0.001). CONCLUSION: Sensate focus technique and sexual position changing improved sexual function in women with deep endometriosis after surgery.
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The results of our study show that the sensate focus technique and sexual position changing can improve sexual function in women with deep endometriosis after surgery. The practice of non-sexual touch to sexual touching in sensate focus technique with training to use sexual positions with less pain, resulting in loss of fear of pain and controlling the pain catastrophization in women, and reducing pain during their sexual relationship. Because endometriosis has a high prevalence in communities and has many negative effects on various aspects of female sexual function, chronic pelvic pain, advanced stages of the disease, and the presence of physical, mental, and psychological diseases affect the sexual function of these women. Even with current treatments, including surgery, these disorders may persist. Despite the proven effectiveness of laparoscopic surgery, the recurrence of postoperative pain symptoms remains a major challenge and an important issue in the long run. Enhancing sexual function should be regarded as the primary clinical objective of endometriosis treatment, as it not only addresses dyspareunia or pain during intercourse but also improves overall quality of life.

Coi Statement

The authors declare that they have no conflict of interest.

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Condition tags

endometriosisdyspareunia

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