Sexual function in infertile women with PCOS and endometriosis

Women having endometriosis are more prone to experience sexual dysfunction compared to those with PCOS.

Key Points

Highlights:

• Both PCOS and endometriosis, frequently encountered in reproductive-aged infertile women, may result in sexual dysfunction.

Importance:

• Sexual health should be evaluated in endometriosis patients to improve their quality of life.

What’s done here?

• This cross-sectional study was conducted in infertile women with endometriosis, polycystic ovary syndrome (PCOS), and healthy women (control group).
• Rotterdam criteria were used to confirm the presence of PCOS. Endometriosis was diagnosed based on histopathologic examination following laparoscopy.
• Demographic and clinical characteristics of the participants were recorded (age, education, occupation, body mass index (BMI), and type of infertility).
• The female sexual function index (FSFI) which is a 19-item patient-reported outcome measure of sexual function, was applied to assess sexual health.
• Mood swings, especially anxiety and depression, were scored using with the hospital anxiety and depression scale.

Key results:

• A total of 630 subjects (210 women with PCOS, 210 women with endometriosis, and 210 women in the control group) were included.
• The level of education, occupation, and type of infertility showed a significant difference between the groups. There was no significant difference in terms of BMI and duration of infertility.
• Endometriosis patients had significantly lower mean total FSFI scores compared to PCOS patients and the control group.
• The mean total score of FSFI of the PCOS group was also significantly lower than the control group.
• Although desire, arousal, and lubrication subscales between the endometriosis and control groups were not different, the score of orgasm, pain, and satisfaction was significantly lower in the endometriosis group compared to others.
• On the other hand, PCOS patients had significantly lower scores of desire, arousal, and lubrication subscales compared to endometriosis and control groups.
• A significant inverse relationship was found between education level and sexual dysfunction.
• The mean score of FSFI was lower in the moderate-severe endometriosis (stages 3 and 4) group compared to stages 1-2.

Strengths and Limitations

• The large sample size was the strength of the study.
• Having little information about the sexual health of participants’ partners and other possible causes of female sexual dysfunction could be accepted as the limitations of the study.

Lay Summary

Women with endometriosis suffer from several symptoms and signs including dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility which have a detrimental effect on their quality of life. Sexual dysfunction also is a common problem for endometriosis patients due to complex biological, psychological, social, and ethical issues. Polycystic ovary syndrome (PCOS), which is the most common endocrinological disease in reproductive-aged women also negatively affects sexual health.

Daneshfar et al., from Iran, published a cross-sectional study titled “Comparison of sexual function in infertile women with polycystic ovary syndrome and endometriosis: A cross-sectional study” in the journal named "International Journal of Reproductive BioMedicine". The authors sought to evaluate whether there was any difference regarding sexual health between the women with endometriosis and PCOS or not.

They used the female sexual function index (FSFI) to assess sexual health and the hospital anxiety and depression scale to score mood swings, especially anxiety and depression.

Endometriosis patients had significantly lower mean total scores of FSFI compared with PCOS patients and the control group. Although desire, arousal, and lubrication subscales between the endometriosis and control groups did not show a significant difference, the score of orgasm, pain, and satisfaction subscales were significantly lower in the endometriosis group compared to PCOS and control groups. Concerning endometriosis stages, as the stage of the disease increased, sexual dysfunction worsened. Low education levels also caused a significant deterioration in sexual health.    

“Sexual dysfunction rates are high in infertile women with endometriosis and PCOS. Infertility service providers in infertility centers need to pay attention to this issue.” the authors added.

Research Source: https://pubmed.ncbi.nlm.nih.gov/36340671/