BEYOND PELVIC PAIN: THE IMPACT OF ENDOMETRIOSIS ON SEXUALITY, FERTILITY, AND QUALITY OF LIFE IN WOMEN OF REPRODUCTIVE AGE

Abstract

Endometriosis is a chronic, estrogen-dependent inflammatory disease characterized by the presence of endometrial-like tissue outside the uterine cavity, affecting a significant proportion of women of reproductive age. Although chronic pelvic pain represents its classic symptom, the consequences of the condition extend far beyond the nociceptive spectrum. The aim of this study was to analyze scientific evidence regarding the impact of endometriosis on sexuality, fertility, and the overall quality of life of women in their fertile years. This integrative literature review was conducted in Medline/PubMed, LILACS, SciELO, and Web of Science databases, encompassing articles published between 2020 and 2026. A total of 18 studies meeting all eligibility criteria were included. Results demonstrate that deep dyspareunia and associated psychological distress cause complex sexual dysfunctions, including reduced desire, anorgasmia, and avoidance of intimacy. In the reproductive domain, pelvic anatomical distortion, altered endometrial receptivity, and diminished ovarian reserve significantly impair fertility, frequently requiring assisted reproductive technologies. Prolonged diagnostic delay and socioemotional burden severely deteriorate quality of life, triggering depressive and anxiety symptoms. In conclusion, endometriosis demands a holistic, interdisciplinary, and individualized therapeutic approach that extends beyond symptomatic pain management to encompass sexual health, reproductive planning, and psychosocial well-being.