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

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.