Endometriosis is a complex gynecological condition that affects approximately 10% of women of reproductive age, according to 2023 data from the World Health Organization. Endometriosis is often associated with debilitating pain, particularly during sexual intercourse (dyspareunia). This pain profoundly affects these patients' sexual health and, consequently, their quality of life, yet it remains frequently misunderstood and inadequately managed, partly due to a lack of information and appropriate tools.
One of the key aspects of this study is the use of the Sexual Activity Questionnaire (SAQ), an internationally recognized assessment tool for measuring the impact of treatment on sexual functioning. The SAQ collects precise data on sexual activity (primarily frequency), the level of sexual pleasure, and the perceived pain potential experienced by patients during sexual activity, assessing not only the intensity of pain but also its influence on the emotional and relational aspects of intimate life. The SAQ has been validated to assess the impact of surgical treatments for endometriosis on sexual functioning.
The results obtained through this questionnaire in routine clinical practice formed the basis for the tools developed by Dr. Magalie Benoit, providing an in-depth understanding of the different types of pain experienced by patients.
The kit used in the study contains:
1. The Endo-Sexo Guide: A 258-page book that compiles and analyzes possible responses to the SAQ. It explains in detail the mechanisms of sexual pain and offers personalized solutions to alleviate it. 2. The Endo Doute app: It allows women to keep a journal tracking pain (frequency and intensity), the frequency of sexual intercourse, and the tools used to relieve pain (including those provided in the kit). It also allows users to export their data to share with the healthcare professionals involved. 3. A set of practical tools for managing sexual pain on a daily basis, including an endo-vaginal TENS device to treat dyspareunia, penis rings to limit deep penetration, hyaluronic acid suppositories, CBD (cannabinoid) lubricant gel, sublingual CBD oil to reduce stress, as well as two dietary supplements-one containing palmitoylethanolamide (PEA) to combat inflammation and the other made from herbs to aid menstrual comfort.
These tools will be used independently by patients, offering them personalized solutions to better understand and manage their pain on their own. Each patient will be able to choose whether or not to use the various components of the kit and how often to use them. Empowering patients to manage their own pain should improve their sexual quality of life and reduce the need for occasional or unscheduled medical care.
This project represents the first initiative aimed at evaluating the impact of these tools on patients' autonomy in managing sexual pain related to endometriosis.
Women aged 18 to 45
Sexually active within the past 3 months
Confirmed diagnosis of endometriosis
Pain during sexual intercourse, as reported by the patient
Patients participating in another interventional clinical trial for endometriosis.
Pregnant, breastfeeding, or laboring women
Patients who do not speak French or are unable to provide informed consent for the study
Patients with an allergy to any component of the study kit
Parallel
Specialized kit
DeviceThe kit used in the study contains: 1. The Endo-Sexo Guide: A 258-page book that compiles and analyzes possible responses to the SAQ. It explains in detail the mechanisms of sexual pain and offers personalized solutions to alleviate it (Guerrier-Benoit 2024) 2. The Endo Doute app: It allows women to keep a journal tracking pain (frequency and intensity), the frequency of sexual intercourse, and the tools used to relieve pain (including those provided in the kit). It also allows users to export their data to share with the healthcare professionals involved. 3. A set of practical tools for managing sexual pain on a daily basis, including an endo-vaginal TENS device to treat dyspareunia, penis rings to limit deep penetration, hyaluronic acid suppositories, CBD (cannabinoid) lubricant gel, sublingual CBD oil to reduce stress, as well as two dietary supplements.
Sexual quality of life at 3 months between kit and no kit
To assess whether using the Endo-Sexo kit improves the quality of sexual life for patients with endometriosis after 3 months of use by comparing patients who use the kit with those who do not. Sexual quality of life will be assessed using the Sexual Activity Questionnaire (SAQ). The difference in total scores between baseline and day 90 will be compared between the two groups. Nine of the ten SAQ items are rated on a 4 point Likert scale from 0 (not at allà to 3 (very much), therefore the total score can go from 0 to 27, with the last item being the frequency of sexual relations. A high score on the pleasure subscale represents high pleasure, and a low score on the discomfort subscale represents low discomfort.
Sexual quality of life after 3 months of specialized kit's use
To assess whether use of the Endo-Sexo kit improves the sexual quality of life of patients with endometriosis by comparing data before and after 3 months of kit use across all study patients. Sexual quality of life will be assessed using the Sexual Activity Questionnaire (SAQ). The difference in the total score between the baseline level and the level at 3 months will be analyzed for all patients (Day 0 vs. Day 90 for Group 1 and Day 90 vs. Day 180 for Group 2). Nine of the ten SAQ items are rated on a 4 point Likert scale from 0 (not at allà to 3 (very much), therefore the total score can go from 0 to 27, with the last item being the frequency of sexual relations. A high score on the pleasure subscale represents high pleasure, and a low score on the discomfort subscale represents low discomfort.
Evaluating the use of the Endo-Sexo kit over a 3 months period
Frequency of use of the kit's various components during the first 3 months of use (based on information entered into the EndoDoute app)
Pelvic pain modulation by specialized kit's use over 3 months
To measure changes in pelvic pain levels (based on data from the EndoDoute app) after 3 months of use by comparing patients who used the kit with those who did not.The difference in the numerical score (from 1 to 5) for pelvic pain between baseline and day 90 (based on information entered into the EndoDoute app) will be studied.
Long-term effect of the specialized kit on sexual quality of life
Assess the long-term effect of the kit (in Group 1 patients only, comparing Day 0, Day 90, and Day 180) Sexual quality of life will be assessed using the Sexual Activity Questionnaire (SAQ). The difference in the total score between baseline and the 3-month mark will be compared to the difference in the total score between baseline and the 6-month mark for patients in Group 1. Nine of the ten SAQ items are rated on a 4 point Likert scale from 0 (not at allà to 3 (very much), therefore the total score can go from 0 to 27, with the last item being the frequency of sexual relations. A high score on the pleasure subscale represents high pleasure, and a low score on the discomfort subscale represents low discomfort.
