Quality of sex life in women with endometriosis and deep dyspareunia

Objective: To characterize sexual function among women with endometriosis and deep dyspareunia (DD). Design: Cross-sectional survey. Setting: University teaching hospital. Patient(s): Three-hundred nine women undergoing surgery because of infertility, pelvic pain, or adnexal masses. Three groups of patients with DD were created: women with deep infiltrating endometriosis of the uterosacral ligament (group U), women with endometriosis without uterosacral ligament lesions (group E), and controls (group C). Intervention(s): Laparoscopy. Main Outcome Measure(s): Sexual function questionnaire. Result(s): The prevalence of DD since the first intercourse was significantly higher among women with endometriosis than in controls (P=.029). When group U was compared with group E and C, the pain score was higher, the number of intercourses per week was reduced, the orgasm was less satisfying, and the patients felt less relaxed and fulfilled after sex. No significant difference was observed in pain score and coital frequency between subjects with monolateral and bilateral lesions of the uterosacral ligament. Conclusion(s): Among subjects with DD, those with deep infiltrating endometriosis of the uterosacral ligament have the most severe impairment of sexual function; the presence of bilateral lesions does not influence the severity of the symptoms. Women with endometriosis have frequently suffered DD during their entire sex lives.