Assessment of Sexual Quality of Life and Satisfaction in Couple Relationships Among Women With Deep Infiltrating Endometriosis and Adenomyosis

My Catastrophizing and Your Catastrophizing: Dyadic Associations of Pain Catastrophizing and the Physical, Psychological, and Relational Well-being of Persons With Endometriosis and Their Partners

OBJECTIVES

Endometriosis, a painful chronic gynecologic condition, contributes to disruptions in multiple areas of life for both those affected and their partner. Pain catastrophizing has been associated with worse pain outcomes and quality of life for women with endometriosis and with more cognitive load for partners. Examining both partners' pain catastrophizing dyadically with our variables of interest will enhance understanding of its associations with the distressing nature of experiencing and responding to pain during sex for couples with endometriosis.

METHODS

Persons with endometriosis experiencing pain during sex and their partners (n=52 couples; 104 individuals) completed online self-report measures of pain catastrophizing, depressive symptoms, sexual satisfaction, and partner responses to pain. Persons with endometriosis reported on pain during sexual activity. Analyses were guided by the Actor-Partner Interdependence Model.

RESULTS

Persons with endometriosis' pain catastrophizing was associated with their higher pain intensity and unpleasantness during sex. When persons with endometriosis reported more pain catastrophizing, they were less sexually satisfied and reported their partners responded more negatively to their pain. When partners reported higher catastrophizing, they were more depressed and responded more negatively to the pain.

DISCUSSION

Consistent with the Communal Coping Model of pain catastrophizing, although meant to elicit support from the environment, the often-deleterious cognitive process of magnifying, ruminating, and feeling helpless about one's pain (or one's partner's pain) is associated with poorer outcomes for the individual with pain and their romantic partner. Implications for pain management include the relevance of involving the partner and attending to the pain cognitions of both members of the couple.

A Systematic Review of the Psychosocial Impact of Endometriosis before and after Treatment

While endometriosis is a common gynecologic disease associated with infertility, the psychosocial impact of endometriosis has not been evaluated against various quality of life (QoL) instruments and compared with other chronic illnesses. We rigorously analyzed the psychosocial burden of endometriosis in adult women and compared standardized and validated QoL scores of women with and without endometriosis, before and following treatment, and against other chronic illnesses. We searched PubMed, PsychINFO Embase, and Cochrane Reviews and ClinicalTrials.gov from January 1990 to December 2022 for publications using a detailed list of search terms related to QoL, endometriosis, and questionnaires. Only English-language publications that evaluated the association between Endometriosis and QoL using standardized and validated questionnaires measured at baseline and following treatment were considered. Four reviewers first performed a title and abstract screening followed by full text-review to finalize included articles. QoL scores of women with endometriosis were measured at baseline and analyzed against women without endometriosis and women with endometriosis who had undergone treatment. Additionally, baseline endometriosis scores were assessed against the published QoL scores of populations with other chronic conditions. Assessment of risk of bias was performed in accordance with Cochrane and Newcastle-Ottawa Scale guidelines. A total of 30 articles were included in this review: 4 randomized trials and 26 observational studies. The diagnosis and experience of women with symptomatic endometriosis had an equal or worse QoL score than that of other chronic conditions including heart disease, diabetes, and breast cancer when compared using the 36-Item Short Form Survey and World Health Organization Quality of Life questionnaires. Evidence showed association between low QoL and infertility, sexual dysfunction, mental health struggles, physical pain, poor sleep and fatigue. QoL scores were lower at baseline compared to following treatment in the majority of these domains. Endometriosis is associated with significant psychosocial burden and impaired QoL scores across baseline measurements in comparison to controls and other chronic illnesses. Medical and surgical interventions significantly decreased experienced burdens and improved QoL of women with endometriosis.

Predictors of social intermediate factors associated with sexual quality of life of women: systematic review and meta-analysis

BACKGROUND

Sexual problems and diminished sexual quality of life can adversely affect the physical, psychological, and emotional health of women. The present study was done to determine the social intermediate factors of health associated with sexual quality of life in women of reproductive age.

DESIGN

Systematic review and Meta-analysis.

DATA SOURCES

Embase, Web of Science, PubMed/Medline (NLM), ProQuest, and CENTRAL.

ELIGIBILITY CRITERIA

Observational studies (cross-sectional, case-control, cohort) from 2010 to 2022 with no language constraints were included. The sexual quality of life, as the main variable of the study, has been evaluated using Symonds women's sexual quality of life scale (SQOL-F). The health social determinants intermediate factors based on WHO model were considered as exposure variables.

DATA EXTRACTION AND SYNTHESIS

The data of included studies were extracted by two independent persons through a researcher-made checklist according to the study aims. Quality assessment of studies was done using Newcastle-Ottawa instrument. R software (Version R-4.2.1) were used for meta-analysis. Publication bias was evaluated by Egger & Begg tests. Sensitivity analysis was done through one-out remove approach.

RESULTS

Eventually, 15 studies were eligible to be included in this systematic review and meta-analysis. Variables of depression, quality of marital relation, body image, self-esteem, physical activity, and sexual function were among the health social intermediate factors associated with sexual quality of life. Publication bias had no effect on the obtained results; no study affecting the results was found through sensitivity analysis.

CONCLUSION

Considering the relationship between modifiable factors and sexual quality of life, it seems that identification of these factors can be an important step towards designing interventional studies to help women experience enhanced sexual quality of life.

Resilience, anxiety, depression, and life satisfaction in women suffering from endometriosis: a mediation model

The main goal of this cross-sectional study was to assess the relationship between resilience and life satisfaction in women suffering from endometriosis and examine anxiety and depression as mediators in this relationship. The study sample included 349 Caucasian women aged from 18 to 56 years (M = 32.94; SD = 6.74) suffering from endometriosis surgically diagnosed and histologically confirmed. The life satisfaction level was assessed by the Satisfaction with Life Scale (SWLS). Unspecific anxiety was evaluated using the General Anxiety Disorder-7 scale (GAD-7). Depression symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). Resilience was measured using the Resilience Assessment Scale (SPP-25). Life satisfaction correlated negatively with anxiety and depression, but positively with resilience. Resilience correlated negatively with anxiety and depression. Anxiety and resilience accounted for 25% of the life satisfaction variance. Depression and resilience explained 35% of the variance in life satisfaction. Among resilience components, personal coping skills, tolerance of negative affect, tolerance of failures and treating life as a challenge, openness to new experiences and a sense of humour, and optimistic life attitude and ability to mobilize in difficult situations were the best predictors of life satisfaction. Anxiety and depression may serve as mediators in the relationship between resilience and life satisfaction. Our results suggested that resilience may be related to life satisfaction in women suffering from endometriosis directly and indirectly as mediated by anxiety and depression.