Sexual Functioning and Quality of Life Among Women With Endometriosis: A French Cross-Sectional Survey

BACKGROUND: Evidence suggests that symptoms of endometriosis related to sexual dysfunction can disrupt intimate and sexual partnerships. The goal of this study was to understand the association between quality of life and sexual functioning and all its components among women with endometriosis. METHODS: We developed an anonymous online survey, which received responses from 1586 French women with endometriosis. We performed multivariable logistic regression to highlight the association between the Female Sexual Functioning Index (FSFI) and its dimensions with quality of life. Interaction analyses allowed subgroup investigation. Adjusted covariables were age, body mass index (BMI), tobacco, education, children, number of symptoms and menopause. We performed logworth analyses to assess the order of the strength relationships between all the components of FSFI. RESULTS: We found that FSFI was mainly associated with quality of life (OR = 1.02 [1.01-1.04], p = 0.002). We observed only two interactions between FSFI and BMI (p = 0.015) and education (p < 0.001). When considering educational subgroups, FSFI level was mainly associated with quality of life among those with a moderate educational level (OR = 1.07 [1.04-1.10], p < 0.001) and when considering BMI subgroups, FSFI level was mainly associated with quality of life among those with a moderate BMI (OR = 1.05 [1.02-1.08], p = 0.002). We did not observe an association between sexual functioning and quality of life among obese and low educational level women. Dyspareunia appeared to be the main component of sexual dysfunction among women with endometriosis (FDR logworth = 9.1, p < 0.001). CONCLUSION: This study underscores the importance of professionals who treat patients with endometriosis addressing sexual dysfunction to ensure their quality of life.