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Clinical Treatment of Deep Infiltrating Endometriosis – Impacts on Sexual Function

Received: 11 April 2021    Accepted: 29 April 2021    Published: 14 May 2021
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Abstract

Objectives: Considering the prevalence of endometriosis in reproductive-age women and its negative impact on life quality, the authors of the present research intended to evaluate the impact of clinical treatment on the sexual function of patients with deep infiltrating endometriosis treated at the Endometriosis and Chronic Pelvic Pain Clinic of HSPE-FMO. Methods: A prospective and comparative observational study was conducted between May 2015 and July 2019 in which data from 43 patients with presumed deep endometriosis were analyzed, including age, parity, surgical and obstetric history and Female Sexual Function Index (FSFI questionnaire). Statistical analysis was performed using multiple regression in order to compare the variables. Results: The mean age of the women who were studied was 39.16 years; all patients were symptomatic and most had rectosigmoid endometriosis (65,1%). The median FSFI total score before treatment was 25.06, with 60,5% of the women classified as having a sexual dysfunction. There was a risk for sexual dysfunction to become permanent following clinical treatment when this dysfunction was established previously. The Poisson multiple regression showed that sexual dysfunction before treatment was associated with a lower FSFI total score after treatment and dysfunction before treatment had a direct correlation with final score smaller than 26.55. Considering the FSFI total scores before and after clinical treatment, there was no significant difference in the improvement rate between groups. Conclusions: Most patients did not show improvement in sexual function after clinical treatment.

Published in Clinical Medicine Research (Volume 10, Issue 3)
DOI 10.11648/j.cmr.20211003.12
Page(s) 67-72
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Endometriosis, Sexuality, Drug Therapy

References
[1] Abrão M. S., Petraglia F., Falcone T., Keckstein, J., Osuga, Y. & Chapron, C. (2015). Deep endometriosis infiltrating the recto-sigmoid: critical factors to consider before management. Human Reproduction Update, 21 (3), 329-339. https://doi.org/10.1093/humupd/dmv003.
[2] Kennedy S., Bergqvist A., Chapron C., D’Hoogde T., Dulseman G., Greb R., Hummelshoj L., Prentice A. & Saridogan E. (2005). ESHRE guideline for the diagnosis and treatment of endometriosis. Human reproduction, 20 (10), 2698-2704. https://doi.org/10.1093/humrep/dei135
[3] Marian S. & Hermanowicz-Szamatowicz K. (2020). Endometriosis - a decade later - still an enigmatic disease. What is the new in the diagnosis and treatment? Gynecological Endocrinology, 36 (2), 104-108. https://doi.org/10.1080/09513590.2019.1675045
[4] Shafrir A. L., Farland L. V., Shah D. K., Harris H. R., Kvaskoff M., Zondevan K. & Missmer S. A. (2018). Risk for and consequences of endometriosis: A critical epidemiologic review. Best Practice & research. Clinical Obstetetrics & Gynaecology, 51, 1-15. https://doi.org/10.1016/j.bpobgyn.2018.06.001
[5] Viganò P., Ottolina J., Bartiromo L., Bonavina G., Schimberni M., Villanacci R. & Candiani M.(2020). Cellular Components Contributing to Fibrosis in Endometriosis: A Literature Review. Journal of Minimaly Invasive Gynecology, 27 (2), 287-295. https://doi.org/10.1016/j.jmig.2019.11.011
[6] Cozzolino M., Coccia M. E., Lazzeri G., Basile F. & Troiano G.. (2019). Variables Associated with Endometriosis-related Pain: A Pilot Study using a Visual Analogue Scale. Revista Brasileira de Ginecologia e Obstetrícia, 41(3), 170-175. https://doi.org/10.1055/s-0039-1679879
[7] Shum L. K., Bedaiwy M. A., Allaire C., Williams C., Noga H., Albert A., Lisonkova S. & Yong P. J. (2018). Deep dyspareunia and sexual quality of life in women with endometriosis. Sexual Medicine, 6 (3), 224–233. https://doi.org/10.1016/j.esxm.2018.04.006
[8] Yela D. A., Quagliato I. P. & Benetti-Pinto C. L. (2020). Quality of Life in Women with Deep Endometriosis: A Cross-Sectional Study. Revista Brasileira de Ginecologia e Obstetrícia, 42 (2), 90-95. https://doi.org/10.1055/s-0040-1708091
[9] Lima R. V., Pereira A. M. G., Bray-Beraldo F., Gazzo C., Martins J. A. & Lopes R. G. C. (2018). Female Sexual Function in women with suspected deep infiltrating endometriosis. Revista Brasileira de Ginecologia e Obstetrícia, 40(3), 115-120. https://doi.org/10.1055/s-0038-1639593
[10] Da Luz R. A., De Deus J. M., Valadares A. L. R. & Conde D. M. (2018). Evaluation of sexual function in Brazilian women with and without chronic pelvic pain. Journal of Pain Reserach, 11, 2761–2767. https://doi.org/10.2147/JPR.S176851
[11] Fairbanks F., Abdo C. H., Baracat E. C. & Podgaec S. (2017). Endometriosis doubles the risk of sexual dysfunction: a cross-sectional study in a large amount of patients. Gynecological Endocrinology, 33 (7), 544-547. https://doi.org/10.1080/09513590.2017.1302421
[12] Kossel A., Cambridge S. B., Wagner U. & Bonhoeffer T. (2001). A caged Ab reveals an immediate/instructive effect of BDNF during hippocampal synaptic potentiation. Proceedings of the National Academy of Sciences of the United States of, 98(23), 14702-14707. https://doi.org/10.1073/pnas.251326998
[13] Leite A. P. L., Moura E. A., Campos A. A. S., Mattar R., Souza E. & Camano L. (2007). Validation of the Female Sexual Function Index in Brazilians pregnants. Revista Brasileira de Ginecologia e Obstetrícia, 29(8), 396-401. https://doi.org/10.1590/S0100-72032007000800003
[14] Rosen R. C., Brown C., Heiman J., Leiblum S., Meston C., Shabsigh R., Ferguson D. & D’Agostinho Jr R. (2000). The Female Sexual Function Index (FSFI): a multidimensinal self-report Instrument for the assessment of female sexual function. Journal of Sex &Marital Therapy, 26 (2), 191-208. https://doi.org/10.1080/009262300278597
[15] Andres M. P., Mendes R. F. P., Hernandes C., Araújo S. E. A. & Podgaec S. (2019). Hormone treatment as first line therapy is safe and relieves pelvic pain in women with bowel endometriosis. Einstein, 17, article eAO4583. Doi: 10.31.744/Einstein.journal/2019AO4583.
[16] Hickey M., Ballard K. & Farquhar C. (2014). Endometriosis. BMJ, 348, g1752. https://doi.org/10.1136/bmj.g1752
[17] Bray-Beraldo F., Pereira A. M. G., Gazzo C., Santos M. P. & Lopes R. G. C. (2018). Surgical Treatment of Intestinal Endometriosis: Outcomes of Three Different Techniques. Revista Brasileira de Ginecologia e Obstetrícia, 40 (7), 390-396. https://doi.org/10.1055/s-0038-1660827
[18] Vercellini P, Frattaruolo MP, Rosati R, Dridi D., Roberto A., Mosconi P., De Giorgi O., Cribiù F. M. & Somigliana E. (2018). Medical Treatment or surgery for colorectal endometriosis? Results of a shared decision-making approach. Human Reprodution, 33 (2), 202-211. https://doi.org/10.1093/humrep/dex364
[19] Wiegel M., Meston C. & Rosen R. (2005). The Female Sexual Function Index (FSFI): cross-validation and development of clinical cutoff scores. Journal of Sex & Marital Therapy, 31(1), 1-20. https://doi.org/10.1080/00926230590475206
[20] Bellelis P., Jr Dias J. A., Podgaec S., Gonzales M., Baracat E. C. & Abraão M. S. (2010). Aspectos epidemiológicos e clínicos da endometriose pélvica – uma série de casos. Revista da Associação Médica Brasileira, 56 (4), 467-471. https://doi.org/10.1590/S0104-42302010000400022
[21] Zarbo C., Brugnera A., Compare A., Secomandi R., Candeloro I., Malandrino C., Betto E., Trezzi G., Rabboni M., Bondi E. & Frigerio L. (2019). Negative metacognitive beliefs predict sexual distress over and above pain in women with endometriosis. Archiches of Women’s mental health, 22(5), 575-582. https://doi.org/10.1007/s00737-018-0928-9
[22] Medeiros L. R., Rosa M. I., Silva B. R., Reis M. E., Simon C. S., Dondossola E. R. & Filho J. S. C. (2015). Accuracy of magnetic resonance in deeply infiltrating endometriosis: a systematic review and meta-analysis. Archives of Gynecology and Obstetric, 291 (3), 611-621. https://doi.org/10.1007/s00404-014-3470-7
[23] Cozzolino M., Magro-Malosso E. R., Tofani L & Coccia M. E. (2018). Evaluation of sexual function in women with deep infiltrating endometriosis. Sexual & Reproductive Healthcare, 16, 6-9. https://doi.org/10.1016/j.srhc.2017.12.005
[24] Sampson J. A. (1927). Metastatic or Embolic Endometriosis, due to the Menstrual Dissemination of Endometrial Tissue into the Venous Circulation. The American Journal of Pathology, 3 (2), 93-110.43.
[25] Zondervan K. T., Phil D., Becker C. M. & Missmer S. A. (2020). Endometriosis. The New England Journal of Medicine, 382, 1244-1256. DOI: 10.1056/NEJMra1810764
[26] Lara L. A. S., Rosa e Silva A. C. J. S., Romão A. P. M. S. & Junqueira F. R. R. (2008). The assessment and management of female sexual dysfunction. Revista Brasielira de Ginecologia e Obstetrícia, 30, 312-321. https://doi.org/10.1590/S0100-72032008000600008.
[27] Mendonça C. R., Silva T. M., Arruda J. T., Garcia-Zapata, M. T. A. & Amaral, W. N. (2012). Função sexual feminina: aspectos normais e patológicos, prevalência no Brasil, diagnóstico e tratamento. Femina, 40, 195-202.
[28] Alkatout I., Mettler L., Beteta C., Hedderich J., Jonat W., Schollmeyer T & Salmassi A. (2013). Combined surgical and hormone therapy for endometriosis is the most effective treatment: prospective, randomized, controlled trial. Journal of Minimaly Invasive Gynecology, 20,473-481. https://doi.org/10.1016/j.jmig.2013.01.019
[29] Dunselman G. A., Vermeulen N., Becker C., Calhaz-Jorge C., D’Hooghe T., De Bie B., Heikinheimo O., Horne A. W., Kiesel L., Nap A., Prentice A., Saridogan E., Soriano D., Nelen W. (2014). ESHRE guideline: management of women with endometriosis. Human Reprodution, 29(3), 400-412. https://doi.org/10.1093/humrep/det457
Cite This Article
  • APA Style

    Lima Ryane Vieira, Lopes Reginaldo Guedes Coelho, Pereira Ana Maria Gomes, Bray-Beraldo Fernando, Gazzo Cláudia, et al. (2021). Clinical Treatment of Deep Infiltrating Endometriosis – Impacts on Sexual Function. Clinical Medicine Research, 10(3), 67-72. https://doi.org/10.11648/j.cmr.20211003.12

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    ACS Style

    Lima Ryane Vieira; Lopes Reginaldo Guedes Coelho; Pereira Ana Maria Gomes; Bray-Beraldo Fernando; Gazzo Cláudia, et al. Clinical Treatment of Deep Infiltrating Endometriosis – Impacts on Sexual Function. Clin. Med. Res. 2021, 10(3), 67-72. doi: 10.11648/j.cmr.20211003.12

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    AMA Style

    Lima Ryane Vieira, Lopes Reginaldo Guedes Coelho, Pereira Ana Maria Gomes, Bray-Beraldo Fernando, Gazzo Cláudia, et al. Clinical Treatment of Deep Infiltrating Endometriosis – Impacts on Sexual Function. Clin Med Res. 2021;10(3):67-72. doi: 10.11648/j.cmr.20211003.12

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  • @article{10.11648/j.cmr.20211003.12,
      author = {Lima Ryane Vieira and Lopes Reginaldo Guedes Coelho and Pereira Ana Maria Gomes and Bray-Beraldo Fernando and Gazzo Cláudia and David Simone Denise and Martins João Alfredo and Pinto Fernando Campos Gomes},
      title = {Clinical Treatment of Deep Infiltrating Endometriosis – Impacts on Sexual Function},
      journal = {Clinical Medicine Research},
      volume = {10},
      number = {3},
      pages = {67-72},
      doi = {10.11648/j.cmr.20211003.12},
      url = {https://doi.org/10.11648/j.cmr.20211003.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20211003.12},
      abstract = {Objectives: Considering the prevalence of endometriosis in reproductive-age women and its negative impact on life quality, the authors of the present research intended to evaluate the impact of clinical treatment on the sexual function of patients with deep infiltrating endometriosis treated at the Endometriosis and Chronic Pelvic Pain Clinic of HSPE-FMO. Methods: A prospective and comparative observational study was conducted between May 2015 and July 2019 in which data from 43 patients with presumed deep endometriosis were analyzed, including age, parity, surgical and obstetric history and Female Sexual Function Index (FSFI questionnaire). Statistical analysis was performed using multiple regression in order to compare the variables. Results: The mean age of the women who were studied was 39.16 years; all patients were symptomatic and most had rectosigmoid endometriosis (65,1%). The median FSFI total score before treatment was 25.06, with 60,5% of the women classified as having a sexual dysfunction. There was a risk for sexual dysfunction to become permanent following clinical treatment when this dysfunction was established previously. The Poisson multiple regression showed that sexual dysfunction before treatment was associated with a lower FSFI total score after treatment and dysfunction before treatment had a direct correlation with final score smaller than 26.55. Considering the FSFI total scores before and after clinical treatment, there was no significant difference in the improvement rate between groups. Conclusions: Most patients did not show improvement in sexual function after clinical treatment.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Clinical Treatment of Deep Infiltrating Endometriosis – Impacts on Sexual Function
    AU  - Lima Ryane Vieira
    AU  - Lopes Reginaldo Guedes Coelho
    AU  - Pereira Ana Maria Gomes
    AU  - Bray-Beraldo Fernando
    AU  - Gazzo Cláudia
    AU  - David Simone Denise
    AU  - Martins João Alfredo
    AU  - Pinto Fernando Campos Gomes
    Y1  - 2021/05/14
    PY  - 2021
    N1  - https://doi.org/10.11648/j.cmr.20211003.12
    DO  - 10.11648/j.cmr.20211003.12
    T2  - Clinical Medicine Research
    JF  - Clinical Medicine Research
    JO  - Clinical Medicine Research
    SP  - 67
    EP  - 72
    PB  - Science Publishing Group
    SN  - 2326-9057
    UR  - https://doi.org/10.11648/j.cmr.20211003.12
    AB  - Objectives: Considering the prevalence of endometriosis in reproductive-age women and its negative impact on life quality, the authors of the present research intended to evaluate the impact of clinical treatment on the sexual function of patients with deep infiltrating endometriosis treated at the Endometriosis and Chronic Pelvic Pain Clinic of HSPE-FMO. Methods: A prospective and comparative observational study was conducted between May 2015 and July 2019 in which data from 43 patients with presumed deep endometriosis were analyzed, including age, parity, surgical and obstetric history and Female Sexual Function Index (FSFI questionnaire). Statistical analysis was performed using multiple regression in order to compare the variables. Results: The mean age of the women who were studied was 39.16 years; all patients were symptomatic and most had rectosigmoid endometriosis (65,1%). The median FSFI total score before treatment was 25.06, with 60,5% of the women classified as having a sexual dysfunction. There was a risk for sexual dysfunction to become permanent following clinical treatment when this dysfunction was established previously. The Poisson multiple regression showed that sexual dysfunction before treatment was associated with a lower FSFI total score after treatment and dysfunction before treatment had a direct correlation with final score smaller than 26.55. Considering the FSFI total scores before and after clinical treatment, there was no significant difference in the improvement rate between groups. Conclusions: Most patients did not show improvement in sexual function after clinical treatment.
    VL  - 10
    IS  - 3
    ER  - 

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Author Information
  • Department of Gynecology, Institute of Medical Assistance to the State Public Servant (IAMSPE), Sao Paulo, Brazil

  • Department of Gynecology, Institute of Medical Assistance to the State Public Servant (IAMSPE), Sao Paulo, Brazil

  • Department of Gynecology, Institute of Medical Assistance to the State Public Servant (IAMSPE), Sao Paulo, Brazil

  • Department of Surgery, IAMSPE, Sao Paulo, Brazil

  • Department of Gynecology, Institute of Medical Assistance to the State Public Servant (IAMSPE), Sao Paulo, Brazil

  • Department of Gynecology, Institute of Medical Assistance to the State Public Servant (IAMSPE), Sao Paulo, Brazil

  • Postgraduate Program in Health Sciences, IAMSPE, Sao Paulo, Brazil

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