Endometriosis and sexual functioning: How much do psycho-emotional factors matter?

Endometriosis is a gynecological condition often associated with genito-pelvic pain. Psycho-emotional factors, such as lack of emotional awareness and/or presence of negative emotions, have an important role on sexual dysfunctions. These factors could be associated with higher pain perception and worse sexual outcomes in endometriosis women. The aim of the present study was to compare the psycho-emotional profile and the sexual functioning of women with and without endometriosis. Methods 35 endometriosis women (Endometriosis Group EG), recruited in the Gynecological Department of the University Hospital of Rome (age 35.49±7.64), and 41 healthy women (Control Group CG) of the general population (age 34.27±7.81), completed a socio-demographic questionnaire, the McGill Pain Questionnaire (MPQ), the Female Sexual Functioning Index (FSFI), the Symptoms Checklist (SCL-90-R), the Toronto Alexithymia Scale (TAS-20), the Positive and Negative Affects Scale (PANAS). Factorial one-way MANOVAs and Independent Samples Test were used to analyze differences between groups. Results EG reported general worse sexual functioning and higher levels of genital pain compared to CG [F(1,73)=7.43 p<.01]. Regarding psycho-emotional profile, EG got worse scores than CG only in Somatization subscale of SCL-90-R [F(1,73)=12.52 p<.006], explaining the 14.6% of variance. Moreover, EG reported more negative emotions toward sexuality, reaching higher scores on Negative Affections Scale of PANAS (t=2.34; df=31; p<.05). No significant differences were found on TAS-20 domains, but some tendencies were highlighted. Conclusion Endometriosis women experienced more negative emotions toward sexuality and a tendency to somatization comparing to healthy women. These aspects may be implicated in their worse sexual functioning. Physical symptoms, such as pain, could imply negative feelings, and lack of emotional awareness could lead to body’s symptoms. Therefore, Results suggest the importance of an integrated approach; treatments should involve also mind-body techniques (pelvic floor exercise, mindfulness, bioenergetics techniques etc.) in which both somatic and mental components of emotions could be taken into account.