Physiological characteristics of reproductive-age patients with female sexual dysfunction and endometriosis (a comparison of clinical and laboratory parameters in different study groups)
DOI:
https://doi.org/10.14739/2310-1210.2024.3.302358Keywords:
endometriosis, female sexual dysfunction, hormonesAbstract
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.
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
Downloads
Published
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)
