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Tajik, P., Shahali, S., & Padmehr, R. (2023). Effects of sensate focus technique and position changing on sexual function of women with deep-infiltrating endometriosis after surgery: A clinical trial study. International Journal of Reproductive BioMedicine (IJRM), 21(6), 509–520. https://doi.org/10.18502/ijrm.v21i6.13638
https://doi.org/10.18502/ijrm.v21i6.13638
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authors
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Parisa Tajik
Parisa Tajik
Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
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Shadab Shahali
Shadab Shahali
Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
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Roya Padmehr
Roya Padmehr
Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran.
Published Date
- Jul 19, 2023
Effects of sensate focus technique and position changing on sexual function of women with deep-infiltrating endometriosis after surgery: A clinical trial study
Abstract
Background: Endometriosis is a disease that affects women throughout their sexual life. Sexual health is, therefore, a major concern for these women.
Objective: This study aimed to assess the effects of the sensate focus technique and position changing on the sexual function of women with deep-infiltrating endometriosis 3-6 months after surgery.
Materials and Methods: This clinical trial study was performed on 80 women with deep endometriosis, aged 18-45 yr, who were referred to the endometriosis clinic of Avicenna fertility center, Tehran, Iran for follow-up after surgery from January to September 2021. They were divided randomly into 2 groups. In the intervention group, 2-hr virtual training sessions were held and the control group only completed the questionnaires without any intervention. Sexual function was evaluated after 4 and 8 wk.
Results: 8 wk after the intervention, the mean score of sexual function in the intervention group was significantly improved (p < 0.001). The mean total score of sexual function in the pre-intervention period reached from 24.16 to 28.31 in 4 wk after the intervention and 29.85 8 wk after the intervention The mean score of sexual pain during the follow-up periods was significantly improved in the intervention group (p < 0.001).
Conclusion: Sensate focus technique and sexual position changing improved sexual function in women with deep endometriosis after surgery.
Key words: Endometriosis, Sexual dysfunction, Dyspareunia.
References
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[13] Di Donato N, Montanari G, Benfenati A, Monti G, Bertoldo V, Mauloni M, et al. Do women with endometriosis have to worry about sex? Eur J Obstet Gynecol Reprod Biol 2014; 179: 69–74.
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[15] Di Donato N, Montanari G, Benfenati A, Monti G, Leonardi D, Bertoldo V, et al. Sexual function in women undergoing surgery for deep infiltrating endometriosis: A comparison with healthy women. J Fam Plann Reprod Health Care 2015; 41: 278–283.
[16] Ahmadnia E, Haseli A, Karamat A. [Therapeutic interventions conducted on improving women’s sexual satisfaction and function during reproductive ages in Iran: A systematic review]. J Mazandaran Univ Med Sci 2017; 27: 146–162. (in Persian)
[17] Banaei M, Tork Zahrani Sh, Pormehr-Yabandeh A, Ozgoli G, Azad M. Investigating the impact of counseling based on PLISSIT model on sexual intimacy and satisfaction of breastfeeding women. Int J Pharm Res Allied Sci 2016; 5: 489–499.
[18] Linschoten M, Weiner L, Avery-Clark C. Sensate focus: A critical literature review. Sex Relat Ther 2016; 31: 230–247.
[19] Avery-Clark C, Weiner L, Adams-Clark AA. Sensate focus for sexual concerns: An updated, critical literature review. Current Sex Health Reports 2019; 11: 84–94.
[20] Hammerli S, Schwartz ASK, Geraedts K, Imesch P, Rauchfuss M, Wolfler MM, et al. Does endometriosis affect sexual activity and satisfaction of the man partner? A comparison of partners from women diagnosed with endometriosis and controls. J Sex Med 2018; 15: 853–865.
[21] Brown J, Crawford TJ, Allen C, Hopewell S, Prentice A. Nonsteroidal anti-inflammatory drugs for pain in women with endometriosis. Cochrane Database Syst Rev 2017; 1: CD004753.
[22] La Rosa VL, Barra F, Chiofalo B, Platania A, Di Guardo F, Conway F, et al. An overview on the relationship between endometriosis and infertility: The impact on sexuality and psychological well-being. J Psychosom Obstet Gynecol 2020; 41: 93–97.
[23] Sanchez-Sanchez B, Navarro-Brazalez B, Arranz- Martin B, Sanchez-Mendez O, de la Rosa-Diaz I, Torres-Lacomba M. The female sexual function index: Transculturally adaptation and psychometric validation in Spanish women. Int J Environ Res Public Health 2020; 17: 994.
[24] Fakhri A, Pakpour AH, Burri A, Morshedi H, Mohammadi Zeidi I. The female sexual function index: Translation and validation of an Iranian version. J Sex Med 2012; 9: 514–523.
[25] Wickström K, Edelstam G. Minimal clinically important difference for pain on the VAS scale and the relation to quality of life in women with endometriosis. Sex Reprod Healthc 2017; 13: 35–40.
[26] Hamdollahi E, Shahali Sh, Lamyian M, Hosseini F. Effects of sensate focus technique on female sexual function after vaginal delivery. Sexologies 2021; 30: e163–e170.
[27] Tajik M, Shahali Sh, Shadjoo Kh. The co-effect of sensate focus technique and sexual position changing on sexual function of women who use medical treatment for endometriosis. J Obstet Gynaecol 2022; 42: 3706–3711.
[28] Seal BN, Meston CM. The impact of body awareness on women’s sexual health: A comprehensive review. Sex Med Rev 2020; 8: 242–255.
[29] Denny E, Mann ChH. Endometriosis-associated dyspareunia: The impact on women’s lives. J Fam Plann Reprod Health Care 2007; 33: 189–193.
[30] Renner SP, Kessler H, Topal N, Proske K, Adler W, Burghaus S, et al. Major and minor complications after anterior rectal resection for deeply infiltrating endometriosis. Arch Gynecol Obstet 2017; 295: 1277– 1285.
[31] Crispi Jr CP, Crispi CP, de Oliveira BRS, de Nadai Filho N, Peixoto-Filho FM, Fonseca MdF. Six-month followup of minimally invasive nerve-sparing complete excision of endometriosis: What about dyspareunia? PLoS One 2021; 16: e0250046.
[32] Ghai V, Jan H, Shakir F, Kent A. Identifying preoperative factors associated with nonresponders in women undergoing comprehensive surgical treatment for endometriosis. J Minim Invasive Gynecol 2020; 27: 141–147.
[2] Rasouli SS, Golparvar M, Ramezani MA, Hasani J. [Comparison of the effectiveness of iranian sexual satisfaction training package and masters & johnson’s approach on marital quality of married people]. J Psychological Sci 2020; 15: 101–110. (in Persian)
[3] Thomas HN, Thurston RC. A biopsychosocial approach to women’s sexual function and dysfunction at midlife: A narrative review. Maturitas 2016; 87: 49– 60.
[4] McCool ME, Zuelke A, Theurich MA, Knuettel H, Ricci C, Apfelbacher Ch. Prevalence of female sexual dysfunction among premenopausal women: A systematic review and meta-analysis of observational studies. Sex Med Rev 2016; 4: 197–212.
[5] Ghiasi A, Keramat A. Prevalence of sexual dysfunction among reproductive-age women in Iran: A systematic review and meta-analysis. J Midwif Reprod Health 2018; 6: 1296–1304.
[6] Barbara G, Pifarotti P, Facchin F, Cortinovis I, Dridi D, Ronchetti C, et al. Impact of mode of delivery on female postpartum sexual functioning: Spontaneous vaginal delivery and operative vaginal delivery vs cesarean section. J Sex Med 2016; 13: 393–401.
[7] Abrao MS, Petraglia F, Falcone T, Keckstein J, Osuga Y, Chapron C. Deep endometriosis infiltrating the recto-sigmoid: critical factors to consider before management. Hum Reprod Update 2015; 21: 329– 339.
[8] Wolthuis AM, Meuleman Ch, Tomassetti C, D’Hooghe T, van Overstraeten AdB, D’Hoore A. Bowel endometriosis: colorectal surgeon’s perspective in a multidisciplinary surgical team. World J Gastroenterol 2014; 20: 15616–15623.
[9] Lagana AS, Vitale SG, Granese R, Palmara V, Ban Frangez H, Vrtacnik-Bokal E, et al. Clinical dynamics of Dienogest for the treatment of endometriosis: from bench to bedside. Exp Opin Drug Metab Toxicol 2017; 13: 593–596.
[10] Bazot M, Darai E. Diagnosis of deep endometriosis: Clinical examination, ultrasonography, magnetic resonance imaging, and other techniques. Fertil Steril 2017; 108: 886–894.
[11] Lagana AS, Vitale SG, Trovato MA, Palmara VI, Rapisarda AMC, Granese R, et al. Full-thickness excision versus shaving by laparoscopy for intestinal deep infiltrating endometriosis: Rationale and potential treatment options. BioMed Res Int 2016; 2016: 3617179.
[12] Mishra VV, Nanda S, Gandhi K, Aggarwal R, Choudhary S, Gondhali R. Female sexual dysfunction in patients with endometriosis: Indian scenario. J Hum Reprod Sci 2016; 9: 250–253.
[13] Di Donato N, Montanari G, Benfenati A, Monti G, Bertoldo V, Mauloni M, et al. Do women with endometriosis have to worry about sex? Eur J Obstet Gynecol Reprod Biol 2014; 179: 69–74.
[14] Fritzer N, Haas D, Oppelt P, Renner St, Hornung D, Wölfler M, et al. More than just bad sex: Sexual dysfunction and distress in patients with endometriosis. Eur J Obstet Gynecol Reprod Biol 2013; 169: 392–396.
[15] Di Donato N, Montanari G, Benfenati A, Monti G, Leonardi D, Bertoldo V, et al. Sexual function in women undergoing surgery for deep infiltrating endometriosis: A comparison with healthy women. J Fam Plann Reprod Health Care 2015; 41: 278–283.
[16] Ahmadnia E, Haseli A, Karamat A. [Therapeutic interventions conducted on improving women’s sexual satisfaction and function during reproductive ages in Iran: A systematic review]. J Mazandaran Univ Med Sci 2017; 27: 146–162. (in Persian)
[17] Banaei M, Tork Zahrani Sh, Pormehr-Yabandeh A, Ozgoli G, Azad M. Investigating the impact of counseling based on PLISSIT model on sexual intimacy and satisfaction of breastfeeding women. Int J Pharm Res Allied Sci 2016; 5: 489–499.
[18] Linschoten M, Weiner L, Avery-Clark C. Sensate focus: A critical literature review. Sex Relat Ther 2016; 31: 230–247.
[19] Avery-Clark C, Weiner L, Adams-Clark AA. Sensate focus for sexual concerns: An updated, critical literature review. Current Sex Health Reports 2019; 11: 84–94.
[20] Hammerli S, Schwartz ASK, Geraedts K, Imesch P, Rauchfuss M, Wolfler MM, et al. Does endometriosis affect sexual activity and satisfaction of the man partner? A comparison of partners from women diagnosed with endometriosis and controls. J Sex Med 2018; 15: 853–865.
[21] Brown J, Crawford TJ, Allen C, Hopewell S, Prentice A. Nonsteroidal anti-inflammatory drugs for pain in women with endometriosis. Cochrane Database Syst Rev 2017; 1: CD004753.
[22] La Rosa VL, Barra F, Chiofalo B, Platania A, Di Guardo F, Conway F, et al. An overview on the relationship between endometriosis and infertility: The impact on sexuality and psychological well-being. J Psychosom Obstet Gynecol 2020; 41: 93–97.
[23] Sanchez-Sanchez B, Navarro-Brazalez B, Arranz- Martin B, Sanchez-Mendez O, de la Rosa-Diaz I, Torres-Lacomba M. The female sexual function index: Transculturally adaptation and psychometric validation in Spanish women. Int J Environ Res Public Health 2020; 17: 994.
[24] Fakhri A, Pakpour AH, Burri A, Morshedi H, Mohammadi Zeidi I. The female sexual function index: Translation and validation of an Iranian version. J Sex Med 2012; 9: 514–523.
[25] Wickström K, Edelstam G. Minimal clinically important difference for pain on the VAS scale and the relation to quality of life in women with endometriosis. Sex Reprod Healthc 2017; 13: 35–40.
[26] Hamdollahi E, Shahali Sh, Lamyian M, Hosseini F. Effects of sensate focus technique on female sexual function after vaginal delivery. Sexologies 2021; 30: e163–e170.
[27] Tajik M, Shahali Sh, Shadjoo Kh. The co-effect of sensate focus technique and sexual position changing on sexual function of women who use medical treatment for endometriosis. J Obstet Gynaecol 2022; 42: 3706–3711.
[28] Seal BN, Meston CM. The impact of body awareness on women’s sexual health: A comprehensive review. Sex Med Rev 2020; 8: 242–255.
[29] Denny E, Mann ChH. Endometriosis-associated dyspareunia: The impact on women’s lives. J Fam Plann Reprod Health Care 2007; 33: 189–193.
[30] Renner SP, Kessler H, Topal N, Proske K, Adler W, Burghaus S, et al. Major and minor complications after anterior rectal resection for deeply infiltrating endometriosis. Arch Gynecol Obstet 2017; 295: 1277– 1285.
[31] Crispi Jr CP, Crispi CP, de Oliveira BRS, de Nadai Filho N, Peixoto-Filho FM, Fonseca MdF. Six-month followup of minimally invasive nerve-sparing complete excision of endometriosis: What about dyspareunia? PLoS One 2021; 16: e0250046.
[32] Ghai V, Jan H, Shakir F, Kent A. Identifying preoperative factors associated with nonresponders in women undergoing comprehensive surgical treatment for endometriosis. J Minim Invasive Gynecol 2020; 27: 141–147.