Endometriosis and the sexual relations of the couples

Endometriosis is a chronic and painful disease that affect sexual function and the couple's relationship.

Key Points

Importance:

• Endometriosis has a serious impact on the partner's sexual function and the quality of life but most of the clinics do not offer therapy for this condition.

Highlights:

• Considering that psychological disturbance and relations also play an important role in sexual function, sexual therapy like reducing the pain in penetration or to switch the sexual technic will be useful when sexual problems cause distress in women with endometriosis.

What's done here:

• Authors from Portugal conducted a systematic review of the impact of endometriosis on sexual function and partner relationships.
• They followed the PRİSMA guidelines and searched electronic databases of Pubmed and Medline to create a working pool between 2000-2020.
• Among potentially relevant 294 articles, after a careful selection, only 10 matched with their criteria about the subject.  

Key Results:

• Ten articles in the published literature describe 582 women with endometriosis and 411 partners.
• De Graff et al. reported that women with endometriosis demonstrated significantly more dyspareunia and impaired sexual function when compared to controls.
• In different studies, male partners reported negative feelings about the diagnosis of endometriosis (92%) like it affected their sexuality (75%)  and day-to-day life moderate to severely.
• Ferrero et al found no significant difference in the satisfaction with the partner, interest in sex, and the variety of sex between DIE and control groups although communication about sex was significantly worse.

Lay Summary

From the viewpoint of endometriotic women, the pain during the penetration is not the only complaint. They also have growing depression and anxiety leading to difficulties with their social and sexual relationship, work, and study. The emotional impact of sub-infertility, the uncertainty of future related repeated surgeries, and the long duration of treatment all aggravate their psychological disturbance. The need to investigate the psychological impact of endometriosis on women was highlighted in the 2013 ESHRE meeting. 

Published studies on this topic were evaluated by Norinho and Ferreira group et al. from Porto, Portugal to review the impact of endometriosis on the couple's relationship and male partners.

This systematic review was recently published in the journal "Facts, Views and Vision in Obstetrics and Gynaecology", which describes 582 women and 411 partners from 10 selected articles from Pubmed and Medline search between 2000-2020.

Fear and pain anticipation are two powerful inhibitors of the sexual response cycle which commonly affect endometriotic women with the presence of recurrent dyspareunia, and are the main contributors to low desire and lubrification.

Very few studies in the literature ask questionnaires to the partners and focused on the impact of endometriosis on their quality of life, sexual function, and relations. Although endometriosis does not affect the desire by partners, the frequency of intercourse and sexual activities were diminished. Most of the clinics offer neither patient nor couples sexual therapy that leads the partners to feel a lack of support besides worry and anger about their future.

"Partners are generally considered a source of support to the patients with endometriosis and future research is needed to investigate ways to address the male partner and the relationship as a whole. Data suggests that male partners should not be overlooked in the treatment of endometriosis and that psychosocial support including sexual and couple therapy might be beneficial.", the authors wrote as a conclusion.

Research Source: https://pubmed.ncbi.nlm.nih.gov/33123695/