Study Identifies Best Questionnaires to Assess Sexual Function in Patients With Endometriosis

The Female Sexual Function Index (FSFI) and the Sexual Activity Questionnaire (SAQ) seem to have the best measurement properties.

Key Points

Highlights

• The Female Sexual Function Index (FSFI) and the Sexual Activity Questionnaire (SAQ) have the best measurement properties to assess sexual function in women with endometriosis.

Importance

• This finding can help the development of new tools in the future to assess sexual function in patients with endometriosis.

What’s done here

• Researchers conducted a literature review and meta-analysis of studies that assessed the sexual quality of life, sexual function, or sexual distress of women with endometriosis.
• A total of 74 articles that evaluated sexual function were found, the FSFI was the most frequently used (34/74), followed by the Female Sexual Distress Scale (9/74) and the (SAQ) (8/74).
• The most commonly used measurement properties were "hypothesis testing" and "responsiveness". 

Key Results

• The PROMs with the high evidence levels for these two measurement properties were the FSFI, and the SAQ.
• The FSFI questionnaire appeared more relevant for evaluating medical treatment, and the SAQ for evaluating surgical treatment.
• Only the Subjective Impact of Dyspareunia Inventory (SIDI) was specific to endometriosis.

Key results:

• The FSFI was more relevant to evaluate medical treatment.
• The SAQ was more relevant to evaluate surgical treatment.

Limitations:

• Only Pubmed was used to search for the publications included in this study.
• Most studies were not designed to analyze the psychometric properties of the questionnaire.

Lay Summary

The Female Sexual Function Index (FSFI) and the Sexual Activity Questionnaire (SAQ) have the best measurement properties according to the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) criteria for the measurement of sexual function in women with endometriosis, according to a new study published in the scientific journal Acta Obstetricia et Gynecologica Scandinavica.

While the FSFI is more suitable for evaluating medical treatment, the SAQ is best for surgical treatment.  The Subjective Impact of Dyspareunia Inventory (SIDI) is the only questionnaire specifically for endometriosis, but its responsiveness “remains to be defined”, according to the study authors.

The authors aimed to identify reported outcome measures that are used to assess sexual function in patients with endometriosis and improve their selection for research and clinical practice.

The team led by Dr. Arnaud Fauconnier from the Department of Reproductive Medicine and Fertility Preservation at University Hospital Antoine Béclère in Clamart and Centre Hospitalier Intercommunal de Poissy-Saint-Germain-en-Laye, Department of Gynecology and Obstetrics in Poissy, France conducted a systematic review of the literature between January 2000 and September 2023. 

They identified the studies published in this period that included women with confirmed endometriosis and that assessed their sexual quality of life, sexual function, or sexual distress. This corresponded to a total of 74 articles. Twenty-five patient-reported outcome measures were used to assess sexual function in the patients. Of these, FSFI was the one that was used the most frequently. 

This was followed by the Female Sexual Distress Scale (FSDS) and the (SAQ).  The researchers also reported that "hypothesis testing" and "responsiveness" were the most commonly used measurement properties. 

Patient-reported outcome measures that had a high level of evidence for these 2 measurement properties were the FSFI, the SAQ, the Short Sexual Functioning Scale (SSFS), the Sexual Satisfaction Scale for Women (SSSW), Sexual Quality of Life-Female (SQLF), the Brief Profile of Female Sexual Function (BFFSF), and the Sexual Health Outcomes in Women Questionnaire (SHOWQ).  The FSFI was more relevant to evaluate medical treatment while the SAQ was more relevant to evaluate surgical treatment.

“Our study will help the development of future tools by providing an overview of all the measurement properties investigated by [patient-reported outcome measures] assessing sexual function in a population of patients with endometriosis,” the authors concluded.

Research Source: https://pubmed.ncbi.nlm.nih.gov/38226426/