Sexual function of women with endometriosis. "When love hurts": a systematic review of the impact of surgical and medical methods of the treatment sexual function of women with endometriosis

• Mekan R. Orazov
• Nosenko E.N.
• Pokul’ L.V.
• Shkreli I.
• Tokaevа E.S.
• Barseghyan L.K.
• Zakirova Ya.R.
• Dmitrii S. Novginov

Abstract

Objective. Endometriosis is a pathological process in which the outside of the uterus occurs benign growth of tissue, the morphological and functional properties of such endometrial. Endometriosis suffer approximately 176 million women of reproductive age worldwide, and that means 1 out of 10. Recently tracked a clear trend towards the rejuvenation of the disease. The international Association of endometriosis was detected early enough, the average age of primary manifestation of endometriosis 7-15,9 years. One out of every four women with endometriosis experience symptoms of dysmenorrhea and dysuria, dichasia, and chronic pelvic pain syn­drome. Clinical phenotypes of disease associated with a high risk of developing dyspareunia. Therefore, endo­metriosis as a chronic, relapsing gynecological disease is a significant cause of sexual dysfunction in women.

Sexuality and sexual function - a complex phenomenon which is formed and is influenced by many social, psychological, biological and hormonal factors. Sexual dysfunction - an important aspect of health and quality of life, which is under the influence of both the disease and therapeutic interventions, especially for gyneco­logical diseases. Endometriosis can have a significant negative impact on various aspects of sexual function and quality of sexual relations.

Aims - to examine the impact of endometriosis symptoms on sexual function in women; to compare the effectiveness of surgical and medicamental methods of treatment of endometriosis in the treatment of female sexual dysfunction.

Material and methods. To form the review on the endometriosis and approaches to its treatment PubMed, EMBASE, Medline and the Cochrane Library were searched for randomized trials in 2000-2016, limited to English literature in the area.

Results. The results of the systematic review data has shown that endometriosis, particularly its symptoms negatively affect various aspects of the female sexual function and dyspareunia is not the only determining factor of their sexual health. Chronic, recurrent pain syndrome, the presence of physical and mental disorders affect not only sexual function, but also personality traits, and life expectations of women suffering from en­dometriosis. In the study, it was found that surgical and medical management of patients with endometriosis leads to a significant improvement of sexual functions in the long term, but not a final cure.

Conclusion. To date none of the proposed strategies for the treatment of endometriosis, including pain associated sexual dysfunction does not lead to its complete cure and prevents relapses avoided, due to mul­tiple multisystem disorders that underlie its etiology and pathogenesis. Sexual function is a multidimensional concept. Therefore, ideally, when the treatment of sexual dysfunction associated with endometriosis, is a multi­functional team, which includes not just gynecologists, and sexologists, and psychologists/psychotherapists. Individualized approach to therapy for each individual women is an important factor for long-term manage­ment of the disease.

Keywords:endometriosis, dyspareunia, sexual dysfunction, surgical and non-surgical management

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