GENERAL GYNECOLOGY Quality of sex life in endometriosis patients with deep dyspareunia before and after laparoscopic treatment A. Lukic 1 • M. Di Properzio 1 • S. De Carlo 1 • F. Nobili 1 • M. Schimberni 1 • P. Bianchi 1 • C. Prestigiacomo 1 • M. Moscarini 1 • D. Caserta 1 Received: 7 August 2014 / Accepted: 27 July 2015 Ó Springer-Verlag Berlin Heidelberg 2015 Abstract Purpose The present work aims at showing how dys- pareunia linked to endometriosis can affect the life of fertile age women and how surgical treatment of endometriosis can relieve painful symptoms and conse- quently improve sex and social life. Methods From a cohort of 320 women with a clinical and instrumental diagnosis of pelvic endometriosis, 67 patients were selected. These patients had deep dyspareunia that underwent laparoscopic surgical treatment. All the patients had filled out a pre- and post-surgery questionnaire. Results Six months after laparoscopic treatment, a sig- nificant reduction of dyspareunia was recorded, per VAS scores. A statistically significant improvement in sex life was observed between the pre- and post-surgical condition: in particular, an increased number of coituses and of non- difficult coituses, a higher number of patients who declared that pain did not negatively affect sexual pleasure and of patients achieving orgasm. Conclusions The quality of the sex life in patients with endometriosis and dyspareunia showed significant improvement 6 months after laparoscopic treatment. In view of the diagnostic delay characterizing this disease and confirmed by our results, it is essential to involve a mul- tidisciplinary team to assess all the signs and symptoms of endometriosis that may appear in a women of fertile age. This clinical approach is able to ensure a treatment that is as personalized as possible and an appropriate follow-up also with the objective of preserving reproductive performance. Keywords Endometriosis Á Chronic pelvic pain Á Dyspareunia Á Female sexual disorders Á Quality of sex life Introduction Endometriosis is a chronic and invalidating pathology affecting about 10 % of the female population of repro- ductive age [1]. The principal symptom is chronic pelvic pain, which can take on different forms according to the location and seriousness of the pathology, and can manifest as dyspareunia, dyschezia, dysmenorrhea, lower urinary tract syndrome, etc. These symptoms have a negative effect on the woman’s overall quality of life and in particular her sex life. The latter is not always given sufficient attention and consideration by the medical profession. Sex has a multifactorial function and is dependent on the functional integrity of the nervous, vascular, hormone, and immune systems. An imbalance in any of these can lead to dysfunction [2]. The localization of endometriosis nodules in regions subject to traction during sexual intercourse, such as the utero-sacral ligaments, as well as adhesions, can account for the pathogenesis of dyspareunia. Dyspareunia, defined as recurrent or persistent genital pain during sexual intercourse [3], is the particular symp- tom that worsens the quality of sex life in women with endometriosis, reducing the number and quality of coituses [4–7]. It is estimated that dyspareunia is present in 60–70 % of women undergoing surgery [8, 9] and between 50 and 90 % in those undergoing medical hormone therapy [10, 11]. & M. Di Properzio matilde.diproperzio@gmail.com 1 Department of Surgical and Medical Sciences and Translational Medicine, Faculty of Medicine and Psicology, ‘‘Sapienza’’, University of Rome, Sant’Andrea Hospital, Via Di Grottarossa, 1035-1039, 00189 Rome, Italy 123 Arch Gynecol Obstet DOI 10.1007/s00404-015-3832-9