ANÁLISE DA QUALIDADE DE VIDA SEXUAL EM MULHERES COM ENDOMETRIOSE EM USO DE TERAPIA HORMONAL

Abstract

Endometriosis is defined by the ectopic implantation of fragments of the endometrium, with a worldwide prevalence between 6% and 10% of all women in menacme and may represent up to 50% of cases of chronic pelvic pain or infertility. Affected pelvic regions can generate deep dyspareunia with altered desire, arousal, and sexual response. This study aimed to evaluate the impact of symptom-controlling therapy on sexual life and to identify the presence of sexual dysfunctions in patients with endometriosis at the gynecology outpatient clinic of HULW, besides classifying sexual satisfaction after the beginning of hormone therapy by Sexual Quotient - Female Version, analyzing the prevalence of sexual dysfunctions according to the Statistical Manual of Mental Disorders, 5th Ed. and associating these disorders to age, symptoms and therapy used. This is a cross-sectional study, with application of questionnaires to 155 women with endometriosis seen at the gynecology clinic of HULW about sexual symptoms before and after six months of hormone therapy use. Data analysis was performed using SPSS software, with use of the Chi-square Test, Fisher's Exact Test and Wilcoxon's Test to verify statistically significant associations, adopting a CI = 95%. The mean age was 30.21 years. Dienogest was in use by 56.12% of women, followed by AHOC, Goserelin and Danazol, used by 36.12%, 5.16% and 2.58%, respectively. The mean degree of dyspareunia after six months of hormone therapy dropped from 2.89 to 0.38, that of dysmenorrhea was 4.83 to 0.21, and the degree of chronic pelvic pain was 2.11 to 0.04, being statistically significant (p < 0.01). In the QS-F classification, 51.0% considered their sexual life in the last six months as Fair to Good, 47.7% as Good to Excellent, and 1.3% as Poor to Fair. Of the total, 65 women reported some sexual disorder, with Sexual Desire Disorder being reported by 20.6%, Sexual Arousal Disorder by 8.4%, Painful Sexual Disorder by 7.7%, and Orgasm Disorder by 5.2%. AHOCs were more associated with Excitation Disorder (46.2%) and Painful Sexual Disorder (58.3%) and Dienogest with Orgasm Disorder (62.5%). The present study showed statistically significant improvement in pain degrees after the use of drug therapy, evidencing good symptomatic control when using these methods, as well as in other studies in the literature. Evidence shows good efficacy of Dienogest before and after surgery, with advantages over AHOCs. Ineffective communication between physician and patient may interfere with pain management. We conclude that the small number of studies on this theme is a limitation to the interpretation of this research. The fear of talking about sex imposes a barrier to the access of accurate information. Stimulating scientific production is a tool to generate better assistance to women, and involving partners in the treatment of endometriosis can improve the quality of the support provided.