The effect of endometriosis on sexual function as assessed with the Female Sexual Function Index: systematic review and meta-analysis

Abstract

Aim

To systematically compare sexual function between non-treated women with and without endometriosis.

Methods

A systematic review was performed on PubMed/Medline, Scopus, EMBASE, Web of Science and Cochrane Library databases searching studies that analyzed sexual function (assessed with the 19-item Female Sexual Function Index [FSFI]), and dyspareunia, chronic pelvic pain and dysmenorrhea (assessed with a visual analogue scale [VAS]) in women with and with endometriosis.

Results

In 4 studies, non-treated women with endometriosis presented a higher risk of female sexual dysfunction (mean total FSFI score ≤ 26.55; OR = 2.38; 95% confidence interval [CI] = 1.12, 5.04). Although mean total FSFI scores were not significantly different between women with and without endometriosis (mean difference [MD] = −2.15; 95% CI −4.96, 0.67); all FSFI domain scores were significantly lower in women with endometriosis (n = 4 studies): desire (MD = −0.43; 95% CI −0.57, −0.19); arousal (MD = −0.66; 95% CI −1.15, −0.17); lubrication (MD = −0.41; 95% CI −0.79, −0.02); orgasm (MD = −0.40; 95% CI −0.73, −0.06); satisfaction (MD = −0.45; 95% CI −0.72, −0.18); and pain (MD = −1.03; 95% CI −1.34, −0.72). Women with endometriosis displayed differences (more severity) in terms of VAS scores (2 studies) for dyspareunia (MD = 1.88; 95% CI 0.38, 3.37) and chronic pelvic pain (MD = 2.92; 95% CI 1.26, 4.58); but not for dysmenorrhea.

Conclusion

Non-treated women with endometriosis displayed altered sexual function as evidenced by lower scores in all FSFI domains, and severity of dyspareunia and chronic pelvic pain.

摘要

目的：系统比较子宫内膜异位症的未治疗患者与非子宫内膜异位症患者的性功能。

方法：对PubMed/Medline, Scopus, EMBASE, Web of Science和Cochrane图书馆数据库进行了系统综述, 搜索分析子宫内膜异位症患者与非子宫内膜异位症患者性功能（应用有19个项目的女性性功能指数调查量表[FSFI]评估）和性交困难, 慢性盆腔痛和痛经（应用视觉模拟量表[VAS]评估）的研究。

结果：在四个研究中, 未接受治疗的子宫内膜异位症女性患女性性功能障碍的风险更高（平均FSFI总分≤26.55； OR = 2.38； 95％ [CI] = 1.12, 5.04）。 尽管子宫内膜异位症的患者与非子宫内膜异位症患者之间的平均总FSFI得分无显著差异（平均差异[MD] = -2.15； 95％CI -4.96, 0.67）；子宫内膜异位症患者的FSFI各项评分均明显降低（n=4项研究）：性欲（MD = -0.43； 95％CI -0.57, -0.19）； 性唤起（MD = -0.66; 95％CI -1.15, -0.17）; 润滑（MD = -0.41; 95％CI -0.79, -0.02）; 性高潮（MD = 0.40; 95％CI -0.73, -0.06）; 满意度（MD = -0.45; 95％CI -0.72, -0.18）; 和疼痛（MD = -1.03; 95％CI -1.34, -0.72）。

子宫内膜异位症的患者表现为性交困难（MD = 1.88; 95％CI 0.38, 3.37）和慢性盆腔痛（MD = 2.92; 95％CI 1.26, 4.58）的VAS评分（两项研究）存在差异（更严重）；但痛经并非如此。

结论:子宫内膜异位症未经治疗的女性出现性功能改变, 在所有FSFI项目中得分都较低, 并且性交困难和慢性盆腔痛。

Keywords:

• Chronic Pelvic Pain
• Dyspareunia
• Endometriosis
• Female Sexual Dysfunction
• Female Sexual Function Index
• Visual Analogue Scale

Acknowledgements

The authors thank Prof. Stefano Angione, from the University of Cagliari (Italy), for providing complementary information about the paper by Melis et al. [21], included in the meta-analysis. The authors also thank Ms. M. Salas Valero for her assistance with the study.

Disclosure statement

The authors report no conflicts of interest and are alone responsible for the content and the writing of the article.