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This 2019 mixed-method thesis studied endometriosis-associated dyspareunia, aiming to systematically describe the symptom, explore measurement approaches, and inform development of a patient-reported outcome measure. In a qualitative interview study, 17 people with clinically-suspected or diagnosed endometriosis described both superficial pain at the vaginal opening and deeper abdominal/pelvic pain, with superficial pain starting at initial penetration and deep pain often triggered by full penetration or certain positions; participants reported that dyspareunia led many to avoid or interrupt intercourse and negatively affected self-esteem and relationships. A cross-sectional analysis of 300 reproductive-aged participants with histologically-confirmed endometriosis found infertility concerns were not associated with more severe deep dyspareunia, but were higher with more severe superficial dyspareunia, with the association persisting after adjustment for confounders (the abstract text is truncated around reporting). This paper is centrally about endometriosis — specifically it investigates and characterizes endometriosis-associated dyspareunia and its measurement.
Abstract
Dyspareunia affects approximately 50% of people with endometriosis. Despite the prevalence of this symptom, it has been neglected in scientific contexts. Advancing the treatment of endometriosis-associated dyspareunia requires that it is adequately understood and measured in clinical research. This work therefore aims to provide a systematic description of dyspareunia, explore novel approaches to measurement, and makes recommendations for the development of an appropriate patient reported outcome measure. I conducted two studies exploring endometriosis-associated dyspareunia, the first of which was a qualitative description of sexual pain. 17 people with clinically-suspected or diagnosed endometriosis completed interviews about their experience of dyspareunia. Participants primarily experienced pain at the vaginal opening (n=7) and pain in the abdomen/pelvis (n=13). Pain at the vaginal opening began with initial penetration whereas deep pain was often triggered by full penetration or certain sexual positions. In general, participants describe superficial dyspareunia as pulling, burning or stinging and deep dyspareunia as sharp, stabbing, or cramping. Dyspareunia caused most participants to avoid or interrupt intercourse and many reported that the pain negatively affected their self-esteem, partner well-being, and/or relationships. The second study was a cross-sectional study that examined the relationship of superficial and deep dyspareunia with infertility concerns among 300 reproductive-aged participants with histologically-confirmed endometriosis. The odds of infertility concerns were not higher among women with more severe deep dyspareunia (OR=1.02, 95% CI: 0.95-1.09, P=.58). However, the odds of infertility concerns were higher among women with more severe superficial dyspareunia (OR=1.09, 95% CI: 1.02-1.16, P=.01); this relationship persisted after adjusting for potential confounders (AOR=1.14, 95% CI: 1.06-1.24, P<.001). Additional analyses indicated that deep dyspareunia and superficial dyspareunia were different constructs. Overall, the results indicated that measures of endometriosis-associated sexual pain should separately quantify both superficial and deep dyspareunia. Visual aids for item stems, appropriate numeric response scales, and the inclusion of items about dyspareunia impact could improve measurement and management of this symptom.
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Dyspareunia uncovered : a mixed method exploration of the neglected symptom of endometriosis Wahl, Kate Judith
Abstract
Dyspareunia affects approximately 50% of people with endometriosis. Despite the prevalence of this symptom, it has been neglected in scientific contexts. Advancing the treatment of endometriosis-associated dyspareunia requires that it is adequately understood and measured in clinical research. This work therefore aims to provide a systematic description of dyspareunia, explore novel approaches to measurement, and makes recommendations for the development of an appropriate patient reported outcome measure.
I conducted two studies exploring endometriosis-associated dyspareunia, the first of which was a qualitative description of sexual pain. 17 people with clinically-suspected or diagnosed endometriosis completed interviews about their experience of dyspareunia. Participants primarily experienced pain at the vaginal opening (n=7) and pain in the abdomen/pelvis (n=13). Pain at the vaginal opening began with initial penetration whereas deep pain was often triggered by full penetration or certain sexual positions. In general, participants describe superficial dyspareunia as pulling, burning or stinging and deep dyspareunia as sharp, stabbing, or cramping. Dyspareunia caused most participants to avoid or interrupt intercourse and many reported that the pain negatively affected their self-esteem, partner well-being, and/or relationships.
The second study was a cross-sectional study that examined the relationship of superficial and deep dyspareunia with infertility concerns among 300 reproductive-aged participants with histologically-confirmed endometriosis. The odds of infertility concerns were not higher among women with more severe deep dyspareunia (OR=1.02, 95% CI: 0.95-1.09, P=.58). However, the odds of infertility concerns were higher among women with more severe superficial dyspareunia (OR=1.09, 95% CI: 1.02-1.16, P=.01); this relationship persisted after adjusting for potential confounders (AOR=1.14, 95% CI: 1.06-1.24, P
Item Metadata
| Title |
Dyspareunia uncovered : a mixed method exploration of the neglected symptom of endometriosis
|
| Creator | |
| Publisher |
University of British Columbia
|
| Date Issued |
2019
|
| Description |
Dyspareunia affects approximately 50% of people with endometriosis. Despite the prevalence of this symptom, it has been neglected in scientific contexts. Advancing the treatment of endometriosis-associated dyspareunia requires that it is adequately understood and measured in clinical research. This work therefore aims to provide a systematic description of dyspareunia, explore novel approaches to measurement, and makes recommendations for the development of an appropriate patient reported outcome measure.
I conducted two studies exploring endometriosis-associated dyspareunia, the first of which was a qualitative description of sexual pain. 17 people with clinically-suspected or diagnosed endometriosis completed interviews about their experience of dyspareunia. Participants primarily experienced pain at the vaginal opening (n=7) and pain in the abdomen/pelvis (n=13). Pain at the vaginal opening began with initial penetration whereas deep pain was often triggered by full penetration or certain sexual positions. In general, participants describe superficial dyspareunia as pulling, burning or stinging and deep dyspareunia as sharp, stabbing, or cramping. Dyspareunia caused most participants to avoid or interrupt intercourse and many reported that the pain negatively affected their self-esteem, partner well-being, and/or relationships.
The second study was a cross-sectional study that examined the relationship of superficial and deep dyspareunia with infertility concerns among 300 reproductive-aged participants with histologically-confirmed endometriosis. The odds of infertility concerns were not higher among women with more severe deep dyspareunia (OR=1.02, 95% CI: 0.95-1.09, P=.58). However, the odds of infertility concerns were higher among women with more severe superficial dyspareunia (OR=1.09, 95% CI: 1.02-1.16, P=.01); this relationship persisted after adjusting for potential confounders (AOR=1.14, 95% CI: 1.06-1.24, P
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| Genre | |
| Type | |
| Language |
eng
|
| Date Available |
2021-08-31
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| Provider |
Vancouver : University of British Columbia Library
|
| Rights |
Attribution-NonCommercial-NoDerivatives 4.0 International
|
| DOI |
10.14288/1.0380544
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| URI | |
| Degree (Theses) | |
| Program (Theses) | |
| Affiliation | |
| Degree Grantor |
University of British Columbia
|
| Graduation Date |
2019-09
|
| Campus | |
| Scholarly Level |
Graduate
|
| Rights URI | |
| Aggregated Source Repository |
DSpace
|
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