Dyspareunia in women with endometriosis – What characterizes women with dyspareunia and endometriosis? Is there an association with specific anatomical lesions?

Endometriosis is a chronic, often progressive disease characterized by symptoms as pelvic pain, dyspareunia, dysmenorrhea, disturbed bleeding patterns or reduced fertility. Current research supports the hypothesis, that specific locations of endometriosis, i.e. those of the uterosacral ligaments (USL) are associated with a higher prevalence of dyspareunia.

Retrospective data from 470 women with confirmed endometriosis was collected from different Swiss and German hospitals. In a self-administered questionnaire designed to investigate quality of life in endometriosis, socio-demographic data, medical, gynaecologic and obstetric history, and different aspects of quality of life were inquired. A total of 90.8% (427) women answered the question about dyspareunia. Out of these 20.4% (87) women who reported to suffer from pain in every or almost every intercourse were considered presenting dyspareunia. Dyspareunia was experienced independently from the ASRM stages, p = 0.61. (i.e. 20% in ASRM I, 16.9% in ASRM II, 21.9% in ASRM III and 21.4% in ASRM IV.) The occurrence of dyspareunia after surgical treatment of an obliterated Douglas (21.2.%), resection of implants on the USL (20.6%) or a resection in the vaginal fornix (21.2%) did not differ significantly.

Further analysis will investigate the occurrence of dyspareunia with additional locations of endometriosis (i.e. adhesions, endometriomas), with duration of the disease and on the background of surgical and medical treatments.

Not only women with lesions of the USL suffer from dyspareunia. Therefore, any women suffering from endometriosis should systematically be counselled, to reduce potential consequences on sexual activity.