"I can't get no satisfaction": deep dyspareunia and sexual functioning in women with rectovaginal endometriosis

Objective: To assess the impact of rectovaginal endometriosis on pain at intercourse and sexual functioning.

Design: Case-control study.

Setting: Academic department.

Patient(s): Case subjects were women with rectovaginal endometriosis (n = 100), and control subjects were women with a surgical diagnosis of peritoneal and/or ovarian endometriosis (n = 100) or without endometriosis (n = 100).

Intervention(s): Questionnaires (visual analogue scale [VAS] and revised Sabbatsberg Sexual Self-Rating Scale [SRS]).

Main outcome measure(s): Frequency and severity of deep dyspareunia and sexual functioning.

Result(s): Deep dyspareunia was reported by 67/100 (67%) women in the rectovaginal endometriosis group, 52/99 (53%) in the peritoneal and/or ovarian endometriosis group, and 24/93 (26%) in the nonendometriosis group. Mean ± SD dyspareunia VAS scores were, respectively, 44 ± 34, 30 ± 32, and 13 ± 26. Women in both endometriosis groups performed significantly worse than those in the nonendometriosis group in several SRS subdomains. No significant difference in overall SRS score was detected between women in the two endometriosis groups.

Conclusion(s): Women with endometriosis experienced more frequent and severe deep dyspareunia and worse sexual functioning compared with women without endometriosis, whereas differences between women with diverse endometriosis forms were marginal.