Palavras-chave
Saúde da Mulher
Qualidade de Vida
Comportamento Sexual
Como Citar
Resumo
Introdução: Endometriose é definida pela presença e crescimento do tecido endometrial fora da cavidade uterina. Estima-se que a proporção de ocorrência entre todas as mulheres seja em torno de 15% na idade reprodutiva, em cerca de 20% das pacientes com dor pélvica crônica e 50% das pacientes com histórico de infertilidade. O Female Sexual Function Index (FSFI) é um questionário sucinto recomendado para avaliar a resposta sexual feminina em seis domínios: desejo, excitação, lubrificação vaginal, orgasmo, satisfação e dor e apresenta 19 questões que avaliam a função sexual nas últimas quatro semanas. Objetivo: Avaliar a qualidade da função sexual em pacientes portadoras de endometriose atendidas em ambulatório, por meio da aplicação do FSFI. Método: Trata-se de estudo descritivo de abordagem quantitativa, realizado no período de fevereiro de 2013 a novembro de 2019. A amostra foi composta por 422 participantes, investigadas as características sociodemográficas, e aplicados os instrumentos para avaliar a intensidade da dor por meio da Escala Visual Analógica e questionário do FSFI para avaliar a função sexual. As pacientes foram agrupadas de acordo com as seguintes características: Dor Pélvica Crônica, Endometriose no Ovário, Endometriose Profunda, Endometriose Associada ao Ovário e Profunda e Aderência. A análise estatística foi feita utilizando o teste T de Student ou ANOVA para comparação de médias e teste Qui-quadrado para comparação de variáveis categóricas. O nível de significância estatística estabelecido foi através de intervalo de confiança de 95%. Resultado: A média de idade das participantes foi de 37,85±7,38 variando entre 18 e 54 anos. Foi observada diferença estatística somente no domínio DOR. Conclusão: As participantes apresentaram primariamente queixas de dor em relação a função sexual, corroborando com os dados do questionário FSFI, o que influencia em diversos fatores sobre a qualidade de vida sexual frente à endometriose. Os achados sugerem a necessidade de rastreamento rotineiro da disfunção sexual em mulheres com endometriose para propiciar diagnóstico e tratamento de modo precoce quanto ao impacto na saúde.
Referências
Olive DL. Endometriosis in Clinical Practice. London and New York: Taylor and Francis 2005.
Janssen EB, Rijkers AC, Hoppenbrouwers K, et al. Prevalence of endometriosis diagnosed by laparoscopy in adolescents with dysmenorrhea or chronic pelvic pain: a systematic review. Hum Reprod Update 2013; 19: 570-582. https://doi.org/10.1093/humupd/dmt016.
Carvalho AP, Olímpia C. Endometriose e disfunção sexual. Acta Obstet Ginecol Port. 2019; 13: 228-234.
Aguiar A, Capela E, Caramelo O, et al. Endometriose: Recomendações de consenso nacionais - clínica e diagnóstico. Acta Obstet Ginecol Port. 2016; 10: 162-172.
Han SJ, Jung SY, Wu SP, et al. Estrogen Receptor β Modulates Apoptosis Complexes and the Inflammasome to Drive the Pathogenesis of Endometriosis. Cell. 2015; 163: 960-974. http://doi.org/10.1016/j.cell.2015.10.034
World Health Organization. Sexual health and its linkages to reproductive health: an operational approach. 20 September 2017.
Desai J, Strong S, Ball E. Holistic approaches to living well with endometriosis. F1000Res. 2024; 13: 359. doi: 10.12688/f1000research.142586.2.
Lagana AS, La Rosa VL, Rapisarda AMC, et al. Anxiety and depression in patients with endometriosis: impact and management challenges. Int J Womens Health. 2017; 9: 323–330.
Nisenblat V, Bossuyt PMM, Shaikh R, et al. Blood biomarkers for the non-invasive diagnosis of endometriosis. Cochrane Database of Systematic Reviews 2016, Issue 5. doi:10.1002/14651858.CD012179.
Bastu E, Celik HG, Kocyigit Y, et al. Improvement in quality of life and pain scores after laparoscopic management of deep endometriosis: a retrospective cohort study. Arch Gynecol Obstet. 2020; 302(1):165–172.
Baser RE, Li Y, Carter J. Psychometric validation of the female sexual function index (FSFI) in cancer survivors. Cancer. 2012;118(18):4606–4618.
Culley L, Law C, Hudson N, et al. A qualitative study of the impact of endometriosis on male partners. Hum Reprod. 2017; 32: 1667–1673, https://doi.org/10.1093/humrep/dex221.
Pérez-López FR, Ornat L, Pérez-Roncero GR et al. 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):1015–1023.
Cervantes GV, Ribeiro PAAG, Tomasi MC, et al. Sexual Function of Patients with Deep Endometriosis after Surgical Treatment: A Systematic Review. Rev Bras Ginecol Obstet. 2023; 45(11):e729-e744. doi: 10.1055/s-0043-1772596.
Della Corte L, Di Filippo C, Gabrielli O, et al. The burden of endometriosis on women’s lifespan: a narrative overview on quality of life and psychosocial wellbeing. Int J Env Res Public Health 2020;17(13):4683
Melis I, Litta P, Nappi L, et al. Sexual Function in Women with Deep Endometriosis: Correlation with Quality of Life, Intensity of Pain, Depression, Anxiety, and Body Image. Int J Sexual Health. 2015; 27: 175-185, doi: 10.1080 / 19317611.2014.952394
Silvia RCPC, Moura KKVO, Júnior CLR, et al. Estrogen signalling in the proliferative endometrium: implications in endometriosis. Rev. Assoc. Med. Bras. 2016;62: 72-77. https://doi.org/10.1590/1806-9282.62.01.72.
Cozzolino M, Coccia ME, Lazzeri G, et al. Variables Associated with Endometriosis related Pain: A Pilot Study using a Visual Analogue Scale. Rev Bras Ginecol Obstet. 2019; 41:170-175. doi:10.1055/s-0039-1679879.
Abdo CH, Oliveira WM Jr, Moreira ED Jr, et al. Prevalence of sexual dysfunctions and correlated conditions in a sample of Brazilian women-results of the Brazilian study on sexual behavior (BSSB). Int J Impot Res. 2004; 16: 160-166.
Bellelis P, Dias Jr JA, Podgaec S, et al. Aspectos epidemiológicos e clínicos da endometriose pélvica: uma série de casos. Rev. Assoc. Med. Bras. 2010; 5:467-71. doi.org/10.1590/S0104-42302010000400022.
Podgaec S. Manual de endometriose. São Paulo: Federação Brasileira das Associações de Ginecologia e Obstetrícia (FEBRASGO), 2014.
Hayes RD. Assessing female sexual dysfunction in epidemiological studies: why is it necessary to measure both low sexual function and sexually-related distress? Sex Health. 2008; 5:215-218. doi: 10.1071/sh08016.
Maserejian NN, Shifren JL, Parish SJ, et al. The presentation of hypoactive sexual desire disorder in premenopausal women. J Sex Med. 2010;7:3439-3448. doi: 10.1111/j.1743-6109.2010.01934.x.
Fritzer N, Haas D, Oppelt P, et al. More than just bad sex: sexual dysfunction and distress in patients with endometriosis. Eur J Obstet Gynecol Reprod Biol. 2013;169:392-396. doi: 10.1016/j.ejogrb.2013.04.001.
Márki G, Bokor A, Rigó J, et al. Physical pain and emotion regulation as the main predictive factors of health-related quality of life in women living with endometriosis. Hum Reprod. 2017;32:1432-1438. doi: 10.1093/humrep/dex091.
Thomtén J, Linton SJ. A Psychological View of Sexual Pain among Women: Applying the Fear-Avoidance Model. Women’s Health 2013;9:251-263.
Troìa L, Luisi S. Sexual function and quality of life in women with endometriosis. Minerva Obstet Gynecol. 2022; Apr 14. doi: 10.23736/S2724-606X.22.05033-3.
Evangelista A, Dantas T, Zendron C, et al. Sexual function in patients with deep infiltrating endometriosis. J Sex Med. 2014; 11:140-145. doi: 10.1111/jsm.12349.
Shi C, Xu H, Zhang T, et al. Endometriosis decreases female sexual function and increases pain severity: a meta-analysis. Arch Gynecol Obstet. 2023;307:195–204. doi.org/10.1007/s00404-022-06478-4
Zhu X, Wu Y, Jia J, et al. Impact of endometriosis on female sexual function: an updated systematic review and meta-analysis. Sex Med. 2023;11(2):qfad026. doi: 10.1093/sexmed/qfad026.
Ferrero S, Esposito F, Abbamonte LH, et al. Quality of sex life in women with endometriosis and deep dyspareunia. Fertil Steril. 2005;83(3):573–579.doi.org/10.1016/j.fertnstert.2004.07.973
Tripoli TM, Sato H, Sartori MG, et al. Evaluation of quality of life and sexual satisfaction in women suffering from chronic pelvic pain with or without endometriosis. J Sex Med. 2011;8(2):497–503. doi.org/10.1111/j.1743-6109.2010.01976.x
Ghajarzadeh M, Davari F. Do Iranian women with endometriosis suffer from sexual dysfunction? Sex Disabil. 2014;32(2):189–195. doi.org/10.1007/s11195-014-9350-z
De Graaff AA, Van Lankveld J, Smits LJ, et al. Dyspareunia and depressive symptoms are associated with impaired sexual functioning in women with endometriosis, whereas sexual functioning in their male partners is not affected. Hum Reprod. 2016;31(11):2577–2586. doi.org/10.1093/humrep/dew215
Giuliani M, Cosmi V, Pierleoni L, et al. Quality of life and sexual satisfaction in women suffering from endometriosis: an Italian preliminary study. Eur J Sexol Sex Health. 2016;25(1):e12–e19. doi.org/10.1016/j.sexol.2015.03.004
Somigliana E, Facchin F, Busnelli A, et al. Natural pregnancy seeking in subfertile women with endometriosis. Reprod Sci. 2020;27(1):389–394. doi.org/10.1007/s43032-019-00068-7
Yang X, Xu X, Lin L, et al. Sexual function in patients with endometriosis: a prospective case-control study in China. J Int Med Res. 2021;49(4):3000605211004388. doi.org/10.1177/03000605211004388
Ashrafi M, Jahangiri N, Jahanian SS, et al. Does prevalence of sexual dysfunction differ among the most common causes of infertility? BMC Womens Health. 2022;22(1):140. doi.org/10.1186/s12905-022-01708-y
Kling JM, Ghaith S, Smith T, et al. Evaluating the link between self-reported endometriosis and female sexual dysfunction. J Sex Med. 2022;19(10):1553–1561. doi.org/10.1016/j.jsxm.2022.07.009
Rossi V, Galizia R, Tripodi F, et al. Endometriosis and sexual functioning: how much do cognitive and psycho-emotional factors matter? Int J Environ Res Public Health. 2022;19(9):5319. doi.org/10.3390/ijerph19095319
Daneshfar Z, Jahanian SS, Jahangiri N. Comparison of sexual function in infertile women with polycystic ovary syndrome and endometriosis: a cross-sectional study. Int J Reprod Biomed. 2022;20(9):761–768. https://doi.org/10.18502/ijrm.v20i9.12066.
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