title: Prevalence and associated factors of female sexual dysfunction in women with endometriosis.
abstract: OBJECTIVE
  The issue of female sexual function is often overlooked in women with endometriosis, especially in mainland China. The objectives of this study were to estimate the prevalence and associated factors of female sexual dysfunction in endometriosis in China.
  
  
  METHODS
  This cross-sectional study was conducted at a referral university hospital in Beijing, Peoples Republic of China from July 2011 to April 2012. Women were recruited among inpatients scheduled for laparoscopic surgery based on signs and symptoms suggestive of endometriosis. Before laparoscopy, a semi-structured questionnaire was used to collect demographic data and disease characteristics. The simplified Chinese version of the Female Sexual Function Index was used to assess sexual function.
  
  
  RESULTS
  A total of 111 consecutive women with histologically confirmed endometriosis were enrolled in this study. The prevalence of female sexual dysfunction was 73% for those with endometriosis. Univariable analysis identified three potential predictors of female sexual dysfunction: pelvic pain intensity; deep infiltrating endometriosis status; and revised American Society for Reproductive Medicine stages. Multivariable analysis showed that moderate-to-severe pelvic pain (adjusted odds ratio [OR] 3.4, 95% confidence interval [CI] 1.3-8.8) and revised American Society for Reproductive Medicine stage III or IV (adjusted OR 4.4, 95% CI 1.3-15.5) were associated with increased risk of having female sexual dysfunction.
  
  
  CONCLUSIONS
  Female sexual dysfunction is common in women with endometriosis, especially for those with severe pelvic pain and advanced stages of endometriosis.
authors: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, and Peking Union Medical College, Beijing, People's Republic of China.
authors: Shuang-Zheng
authors: SZ
authors: Jia
authors: Jin-Hua
authors: JH
authors: Leng
authors: Peng-Ran
authors: PR
authors: Sun
authors: Jing-He
authors: JH
authors: Lang
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004715:Endometriosis / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006801:Humans; D017699:Pelvic Pain / Q000150:complications; D015995:Prevalence; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology / Q000209:etiology*
references: Giudice LC. Clinical practice. Endometriosis. N Engl J Med 2010;362:2389–98.
references: Rogers PA, D'Hooghe TM, Fazleabas A, Gargett CE, Giudice LC, Montgomery GW, et al.. Priorities for endometriosis research: recommendations from an international consensus workshop. Reprod Sci 2009;16:335–46.
references: Marques A, Bahamondes L, Aldrighi JM, Petta CA. Quality of life in Brazilian women with endometriosis assessed through a medical outcome questionnaire. J Reprod Med 2004;49:115–20.
references: Ferrero S, Esposito F, Abbamonte LH, Anserini P, Remorgida V, Ragni N. Quality of sex life in women with endometriosis and deep dyspareunia. Fertil Steril 2005;83:573–9.
references: Ferrero S, Abbamonte LH, Parisi M, Ragni N, Remorgida V. Dyspareunia and quality of sex life after laparoscopic excision of endometriosis and postoperative administration of triptorelin. Fertil Steril 2007;87:227–9.
references: Vercellini P, De Giorgi O, Mosconi P, Stellato G, Vicentini S, Crosignani PG. Cyproterone acetate versus a continuous monophasic oral contraceptive in the treatment of recurrent pelvic pain after conservative surgery for symptomatic endometriosis. Fertil Steril 2002;77:52–61.
references: Guzick DS, Huang LS, Broadman BA, Nealon M, Hornstein MD. Randomized trial of leuprolide versus continuous oral contraceptives in the treatment of endometriosis-associated pelvic pain. Fertil Steril 2011;95:1568–73.
references: Vercellini P, Aimi G, Busacca M, Apolone G, Uglietti A, Crosignani PG. Laparoscopic uterosacral ligament resection for dysmenorrhea associated with endometriosis: results of a randomized, controlled trial. Fertil Steril 2003;80:310–9.
references: Abbott J, Hawe J, Hunter D, Holmes M, Finn P, Garry R. Laparoscopic excision of endometriosis: a randomized, placebo-controlled trial. Fertil Steril 2004;82:878–84.
references: Ferrero S, Ragni N, Remorgida V. Deep dyspareunia: causes, treatments, and results. Curr Opin Obstet Gynecol 2008;20:394–9.
references: Denny E, Mann CH. Endometriosis-associated dyspareunia: the impact on women's lives. J Fam Plann Reprod Health Care 2007;33:189–93.
references: ter Kuile MM, Weijenborg PT, Spinhoven P. Sexual functioning in women with chronic pelvic pain: the role of anxiety and depression. J Sex Med 2010;7:1901–10.
references: Keskin U, Coksuer H, Gungor S, Ercan CM, Karasahin KE, Baser I. Differences in prevalence of sexual dysfunction between primary and secondary infertile women. Fertil Steril 2011;96:1213–7.
references: Vercellini P, Meana M, Hummelshoj L, Somigliana E, Vigano P, Fedele L. Priorities for endometriosis research: a proposed focus on deep dyspareunia. Reprod Sci 2011;18:114–8.
references: Parish WL, Laumann EO, Pan S, Hao Y. Sexual dysfunctions in urban china: a population-based national survey of men and women. J Sex Med 2007;4:1559–74.
references: Vercellini P, Fedele L, Aimi G, Pietropaolo G, Consonni D, Crosignani PG. Association between endometriosis stage, lesion type, patient characteristics and severity of pelvic pain symptoms: a multivariate analysis of over 1000 patients. Hum Reprod 2007;22:266–71.
references: Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, et al.. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 2000;26:191–208.
references: Sand M, Rosen R, Meston C, Brotto LA. The female sexual function index (FSFI): a potential “gold standard” measure for assessing therapeutically-induced change in female sexual function. Fertil Steril 2009;92:S129.
references: Tsai TY, Chen SY, Tsai MH, Su YL, Ho CM, Su HF. Prevalence and associated factors of sexual dysfunction in cervical cancer patients. J Sex Med 2011;8:1789–96.
references: Sun X, Li C, Jin L, Fan Y, Wang D. Development and validation of Chinese version of female sexual function index in a Chinese population-a pilot study. J Sex Med 2011;8:1101–11.
references: Wiegel M, Meston C, Rosen R. The female sexual function index (FSFI): cross-validation and development of clinical cutoff scores. J Sex Marital Ther 2005;31:1–20.
references: Revised American Society for Reproductive Medicine classification of endometriosis: 1996. Fertil Steril 1997;67:817–21.
references: Donovan KA, Taliaferro LA, Alvarez EM, Jacobsen PB, Roetzheim RG, Wenham RM. Sexual health in women treated for cervical cancer: characteristics and correlates. Gynecol Oncol 2007;104:428–34.
references: Verit FF, Verit A, Yeni E. The prevalence of sexual dysfunction and associated risk factors in women with chronic pelvic pain: a cross-sectional study. Arch Gynecol Obstet 2006;274:297–302.
references: Tripoli TM, Sato H, Sartori MG, de Araujo FF, Girao MJ, Schor E. Evaluation of quality of life and sexual satisfaction in women suffering from chronic pelvic pain with or without endometriosis. J Sex Med 2011;8:497–503.
references: Dai Y, Leng JH, Lang JH, Li XY, Zhang JJ. Anatomical distribution of pelvic deep infiltrating endometriosis and its relationship with pain symptoms. Chin Med J (Engl) 2012;125:209–13.
references: Chapron C, Santulli P, de Ziegler D, Noel JC, Anaf V, Streuli I, et al.. Ovarian endometrioma: severe pelvic pain is associated with deeply infiltrating endometriosis. Hum Reprod 2012;27:702–11.
references: Berkley KJ, Rapkin AJ, Papka RE. The pains of endometriosis. Science 2005;308:1587–9.
references: Safarinejad MR. Female sexual dysfunction in a population-based study in Iran: prevalence and associated risk factors. Int J Impot Res 2006;18:382–95.