Physiological characteristics of reproductive-age patients with female sexual dysfunction and endometriosis (a comparison of clinical and laboratory parameters in different study groups)

Authors

DOI:

https://doi.org/10.14739/2310-1210.2024.3.302358

Keywords:

endometriosis, female sexual dysfunction, hormones

Abstract

Endometriosis is an estrogen-dependent inflammatory disease that affects 5–10 % of reproductive-age women. About two-thirds of women with endometriosis have sexual dysfunction caused by dyspareunia, which negatively affects the quality of life and mental health of a woman.

The aim of the study is to identify differences in clinical and laboratory parameters in study groups of reproductive-age female patients with the aim of obtaining information about specifics of the female sexual dysfunction (FSD) development in women with endometriosis.

Materials and methods. The examination results of the hormonal profile, sexual functional index and other laboratory markers were analyzed in 130 women of active reproductive age: Group I (n = 100) – the main group – women with manifestations of FSD including subgroup IA (n = 70) – women with FSD and external genital endometriosis and IB subgroup (n = 30) – women with FSD alone; Group II (n = 30) – healthy women.

Results. Women with endometriosis combined with FSD (IA) exhibited a reproductive hormonal profile different from that in women with FSD (IB), which was seen by a significant difference in follicle-stimulating hormone (FSH), estradiol, free testosterone and dehydroepiandrosterone sulfate values (p = 0.001, p = 0.039, p = 0.035 and p = 0.035, respectively). Vitamin D deficiency and hyperhomocysteinemia, the presence of antibodies to thyroperoxidase and functional hyperprolactinemia have been detected in all the women with FSD signs, regardless of the concomitant endometriosis presence. Post-hoc analysis (Mann–Whitney test) has shown that the mean scores for all categories of the Female Sexual Function Index (FSFI) questionnaire were statistically significantly higher in Group IA patients compared to those in Group II patients (p < 0.001).

Conclusions. The hormonal profile of women with endometriosis is characterized by increased levels of FSH, estradiol, free testosterone and dehydroepiandrosterone sulfate as compared to that in women with FSD alone, however it does not prevent the development of FSD signs in them and is accompanied by different indicators of the FSFI domains.

Author Biographies

O. I. Kryzhanovska, Bogomolets National Medical University, Kyiv, Ukraine

MD, PhD student of the Department of Obstetrics, Gynecology and Neonatology of the IPE, Bogomolets National Medical University; Municipal Non-Commercial Enterprise “Kyiv City Maternity Hospital No. 5”, Kyiv

L. M. Semeniuk, Ukrainian Scientific and Practical Center for Endocrine Surgery, Transplantation of Endocrine Organs and Tissues of the Ministry of Health of Ukraine, Kyiv

MD, PhD, DSc, Professor, Head of the Department of Reproductive Medicine and Surgery

References

Tan J, Taskin O, Iews M, Lee AJ, Kan A, Rowe T, et al. Atherosclerotic cardiovascular disease in women with endometriosis: a systematic review of risk factors and prospects for early surveillance. Reprod Biomed Online. 2019;39(6):1007-16. doi: https://doi.org/10.1016/j.rbmo.2019.05.021

Tsamantioti ES, Mahdy H. Endometriosis. [Updated 2023 Jan 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK567777/

Paulo Leonardo-Pinto J, Laguna Benetti-Pinto C, Angerame Yela D. When Solving Dyspareunia Is Not Enough to Restore Sexual Function in Women with Deep Infiltrating Endometriosis Treated with Dienogest. J Sex Marital Ther. 2019;45(1):44-9. doi: https://doi.org/10.1080/0092623X.2018.1474411

Zondervan KT, Becker CM, Missmer SA. Endometriosis. N Engl J Med. 2020;382(13):1244-56. doi: https://doi.org/10.1056/NEJMra1810764

Pérez-López FR, Ornat L, Pérez-Roncero GR, López-Baena MT, Sánchez-Prieto M, Chedraui P. The effect of endometriosis on sexual function as assessed with the Female Sexual Function Index: systematic review and meta-analysis. Gynecol Endocrinol. 2020;36(11):1015-23. doi: https://doi.org/10.1080/09513590.2020.1812570

Rossi V, Galizia R, Tripodi F, Simonelli C, Porpora MG, Nimbi FM. Endometriosis and Sexual Functioning: How Much Do Cognitive and Psycho-Emotional Factors Matter? Int J Environ Res Public Health. 2022;19(9):5319. doi: https://doi.org/10.3390/ijerph19095319

Xie B, Liao M, Huang Y, Hang F, Ma N, Hu Q, et al. Association between vitamin D and endometriosis among American women: National Health and Nutrition Examination Survey. PLoS One. 2024;19(1):e0296190. doi: https://doi.org/10.1371/journal.pone.0296190

Guedes T, Santos AA, Vieira-Neto FH, Bianco B, Barbosa CP, Christofolini DM. Folate metabolism abnormalities in infertile patients with endometriosis. Biomark Med. 2022;16(7):549-57. doi: https://doi.org/10.2217/bmm-2021-0076

Rafi U, Ahmad S, Bokhari SS, Iqbal MA, Zia A, Khan MA, et al. Association of Inflammatory Markers/Cytokines with Cardiovascular Risk Manifestation in Patients with Endometriosis. Mediators Inflamm. 2021;2021:3425560. doi: https://doi.org/10.1155/2021/3425560

Both S, Lew-Starowicz M, Luria M, Sartorius G, Maseroli E, Tripodi F, et al. Hormonal Contraception and Female Sexuality: Position Statements from the European Society of Sexual Medicine (ESSM). J Sex Med. 2019;16(11):1681-95. doi: https://doi.org/10.1016/j.jsxm.2019.08.005

World Health Organization (WHO). International classification of diseases (ICD-11). ICD-11 for motality and morbity statistics [Internet]. Geneva: WHO; 2021 [cited 2024 May 2]. Available from: https://icd.who.int/browse11

Pashko AO. Statystychnyi analiz danykh [Statistical data analysis]. Taras Shevchenko National University of Kyiv: Kyiv; 2019 [cited 2024 May 2]. Ukrainian. Available from: https://csc.knu.ua/media/filer_public/19/d5/19d56780-269a-4eef-bb3b-48ec8da23859/intelektualnaobrobkadanikh.pdf

Abdelsamea GA, Amr M, Tolba AM, Elboraie HO, Soliman A, Al-Amir Hassan B, et al. Impact of weight loss on sexual and psychological functions and quality of life in females with sexual dysfunction: A forgotten avenue. Front Psychol. 2023;14:1090256. doi: https://doi.org/10.3389/fpsyg.2023.1090256

Romero-Gómez B, Guerrero-Alonso P, Carmona-Torres JM, Laredo-Aguilera JA, Pozuelo-Carrascosa DP, Cobo-Cuenca AI. Sexual Function in Levothyroxine-Treated Hypothyroid Women and Women without Hypothyroidism: A Case-Control. Int J Environ Res Public Health. 2020;17(12):4325. doi: https://doi.org/10.3390/ijerph17124325

Bates JN, Kohn TP, Pastuszak AW. Effect of Thyroid Hormone Derangements on Sexual Function in Men and Women. Sex Med Rev. 2020;8(2):217-30. doi: https://doi.org/10.1016/j.sxmr.2018.09.005

Gabrielson AT, Sartor RA, Hellstrom WJ. The Impact of Thyroid Disease on Sexual Dysfunction in Men and Women. Sex Med Rev. 2019;7(1):57-70. doi: https://doi.org/10.1016/j.sxmr.2018.05.002

Published

2024-05-31

How to Cite

1.
Kryzhanovska OI, Semeniuk LM. Physiological characteristics of reproductive-age patients with female sexual dysfunction and endometriosis (a comparison of clinical and laboratory parameters in different study groups). Zaporozhye Medical Journal [Internet]. 2024May31 [cited 2024Jul.25];26(3):210-6. Available from: http://zmj.zsmu.edu.ua/article/view/302358