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Exploring Urologic Chronic Pelvic Pain Syndrome on Female Sexual Function

UCPPS patients may have a higher risk for dyspareunia and other sexual dysfunctions.

A PPM Brief

Urologic chronic pelvic pain syndrome (UCPPS) often presents with bladder pain syndrome/interstitial cystitis (BPS/IC) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), featuring symptoms such as chronic pain or discomfort in the lower abdomen/pelvic area, and/or genitourinary genitalia; bladder and lower urinary tract problems; and sexual dysfunction. While research to date has suggested that the syndrome negatively affects the quality of life, emotional status, and sexual function of patients and their spouses, studies have primarily focused on assessing only male sexual function. To counteract this, researchers recently explored1 the effect of UCPPS on female sexual function.

Female sexual dysfunction (FSD) is measured by the Female Sexual Function Index (FSFI), a validated instrument providing an overall assessment of six key domains (desire, arousal, lubrication, orgasm, satisfaction, and pain). Each domain scores from 0 to 6 points; an FSFI total score is 2 to 36 points, with higher scores indicating better function. An FSFI total score of 26.55 has been shown to be the best cutoff for FSD.

Researchers turned their focus on female sexual function with pelvic pain syndromes. (Source: 123RF)

The team utilized key databases (eg, PubMed, EMBASE, Cochrane Library, Google Scholar) to search for cases and/or reporting of FSFI and dyspareunia. They identified cases with the following inclusion criteria: 18-year-old females with a diagnosis of IC/BPS or CPPS with urologic symptoms presenting a majority of the time during any 3 days in the past 3 to 6 months, and/or reporting a non-zero score for bladder and/or pelvic region pain, pressure, or discomfort over the prior 2 weeks.

In all, nine case-control studies enrolling 4,965 subjects were investigated. According to the meta-analysis, UCPPS demonstrated having a significantly negative effect on female sexual function (particularly for lubrication and pain), and UCPPS patients had a significantly higher risk of experiencing dyspareunia (OR = 11.27, 95% CI: 5.15-24.67, P < 0.00001). Results further indicated that:

  • The UCPPS group had significantly lower scores in each domain of the FSFI compared with the healthy control group (total score: MD = −11.35, 95% CI: −14.54 − 8.16, P < 0.00001):
  • desire (MD= −1.04, 95% CI: −1.20 − 0.88, P < 0.00001)
  • arousal (MD = −1.78, 95% CI: −2.36 − 1.20, P < 0.00001)
  • lubrication (MD= −2.11, 95% CI: −2.49 − 1.73, P < 0.00001)
  • orgasm (MD= −1.50, 95% CI: −1.72 − 1.28, P < 0.00001)
  • satisfaction (MD = −1.54, 95% CI: −1.97 − 1.12, P < 0.00001)
  • pain (MD = −2.89, 95% CI: −3.63 − 2.14, P < 0.00001).

“Aging, reduced estrogen levels, and psychosocial variables may be the potential pathogenic mechanism of FSD,” the researchers concluded. “Future well-designed research is called for to develop a comprehensive estimate of the association between UCPPS and FSD.”

Last updated on: September 27, 2019
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