The effect of endometriosis on sexual function as assessed with the Female Sexual Function Index: systematic review and meta-analysis

Aim: To systematically compare sexual function between non-treated women with and without endometriosis. Methods: A systematic review was performed on PubMed/Medline, Scopus, EMBASE, Web of Science and Cochrane Library databases searching studies that analyzed sexual function (assessed with the 19-item Female Sexual Function Index [FSFI]), and dyspareunia, chronic pelvic pain and dysmenorrhea (assessed with a visual analogue scale [VAS]) in women with and with endometriosis. Results: In 4 studies, non-treated women with endometriosis presented a higher risk of female sexual dysfunction (mean total FSFI score ≤ 26.55; OR = 2.38; 95% confidence interval [CI] = 1.12, 5.04). Although mean total FSFI scores were not significantly different between women with and without endometriosis (mean difference [MD] = −2.15; 95% CI −4.96, 0.67); all FSFI domain scores were significantly lower in women with endometriosis (n = 4 studies): desire (MD = −0.43; 95% CI −0.57, −0.19); arousal (MD = −0.66; 95% CI −1.15, −0.17); lubrication (MD = −0.41; 95% CI −0.79, −0.02); orgasm (MD = −0.40; 95% CI −0.73, −0.06); satisfaction (MD = −0.45; 95% CI −0.72, −0.18); and pain (MD = −1.03; 95% CI −1.34, −0.72). Women with endometriosis displayed differences (more severity) in terms of VAS scores (2 studies) for dyspareunia (MD = 1.88; 95% CI 0.38, 3.37) and chronic pelvic pain (MD = 2.92; 95% CI 1.26, 4.58); but not for dysmenorrhea. Conclusion: Non-treated women with endometriosis displayed altered sexual function as evidenced by lower scores in all FSFI domains, and severity of dyspareunia and chronic pelvic pain.