Endometriosis and Sexual Quality of Life

Mikal van Poll; Esther van Barneveld; Luca Aerts; Jacques W M Maas; Arianne C Lim; Bianca T A de Greef; Marlies Y Bongers; Nehalennia van Hanegem

doi:10.1016/j.esxm.2020.06.004

Endometriosis and Sexual Quality of Life

Sex Med. 2020 Sep;8(3):532-544. doi: 10.1016/j.esxm.2020.06.004. Epub 2020 Jul 22.

Authors

Mikal van Poll¹, Esther van Barneveld², Luca Aerts², Jacques W M Maas³, Arianne C Lim², Bianca T A de Greef⁴, Marlies Y Bongers⁵, Nehalennia van Hanegem²

Affiliations

¹ Department of Obstetrics and Gynaecology, Endometriosis Team, Maastricht University Medical Centre, Maastricht, the Netherlands. Electronic address: mikalvanpoll@gmail.com.
² Department of Obstetrics and Gynaecology, Endometriosis Team, Maastricht University Medical Centre, Maastricht, the Netherlands.
³ Department of Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, the Netherlands.
⁴ Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, the Netherlands.
⁵ Department of Obstetrics and Gynaecology, Endometriosis Team, Maastricht University Medical Centre, Maastricht, the Netherlands; Department of Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, the Netherlands.

Abstract

Introduction: Endometriosis is a benign gynecological disease with a high disease burden and significant, multifaceted impact on health-related quality of life (HRQoL) and sexual quality of life (SQoL).

Aim: To explore which patient- and disease-specific characteristics were independently associated with SQoL.

Methods: A literature search was carried out to identify characteristics with an evidence-based or hypothesized effect on SQoL. Subsequently, data on HRQoL in women with endometriosis (n = 224), collected between 2013 and 2018 in a prospective longitudinal Dutch cohort study performed in 7 referral centers, were used to perform a cross-sectional cohort study. Data were collected using an online self-administered survey including the validated Endometriosis Health Profile-30. Inclusion criteria were recently diagnosed endometriosis patients or newly referred patients with a clinical diagnosis of endometriosis. Patients were excluded in case of incomplete answers on the SQoL questions. Univariate analyses and multiple linear regression analyses were performed.

Outcomes: SQoL, measured by the 5-item "sexual intercourse" dimension score of the modular Endometriosis Health Profile-30 questionnaire, was the primary outcome with scores ranging from 0 to 100 (0 indicating the best and 100 indicating the worst health status).

Results: Based on a literature search, 29 characteristics potentially associated with SQoL were selected from the survey and included in the analyses. In total, 192 women (mean age 36 years) met the inclusion criteria. The majority of women (86.5%) had had intercourse in the period before completing the survey and the study population showed a mean SQoL score of 47.5 ± 29.6, indicating moderate SQoL. Worse SQoL was independently associated with dyspareunia (P < .001), worse HRQoL (P = .001), severity of dysmenorrhea (P = .017), and unemployed work status (P = .022).

Conclusion: In a cohort of women with endometriosis, worse SQoL was significantly and independently associated with the presence of dyspareunia, more severe dysmenorrhea, worse HRQoL, and unemployed work status. van Poll M, van Barneveld E, Aerts L, et al. Endometriosis and Sexual Quality of Life. Sex Med 2020;8:532-544.

Keywords: Endometriosis; Endometriosis Health Profile-30; Health-Related Quality of Life; Sexual Quality of Life; Sexuality.