{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T02:22:32Z","timestamp":1784168552796,"version":"3.55.0"},"reference-count":43,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T00:00:00Z","timestamp":1721692800000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["PJT-156084"],"award-info":[{"award-number":["PJT-156084"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Pelvic pain worsened by orgasm is a poorly understood symptom in patients with endometriosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>To assess the prevalence of pelvic pain worsened by orgasm in patients with endometriosis and explore its association with potential etiologic factors, including pelvic floor myalgia, uterine tenderness and adenomyosis, and central nervous system sensitization.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>An analysis was done of a prospective data registry based at a tertiary referral center for endometriosis. Eligible participants were patients aged 18 to 50 years who were referred between January 1, 2018, and December 31, 2019, diagnosed with endometriosis, and subsequently underwent surgery at the center. Clinical features were compared between participants reporting worsening pelvic pain with orgasm and those without worsening pain with orgasm, including patient-reported variables, physical examination findings, and anatomic phenotyping at the time of surgery. Pelvic floor myalgia and uterine tenderness were assessed by palpation on pelvic examination, adenomyosis by ultrasound, and central nervous system sensitization via the Central Sensitization Inventory (range, 0-100).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcomes<\/jats:title>\n                  <jats:p>Outcomes included pelvic or lower abdominal pain in the last 3\u00a0months that worsened with orgasm (yes\/no).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 358 participants with endometriosis, 14% (49\/358) reported pain worsened by orgasm while 86% (309\/358) did not. Pain with orgasm was significantly associated with pelvic floor myalgia (55% [27\/49] vs 35% [109\/309]; Cohen\u2019s h\u2009=\u20090.40, P = .01) and higher scores on the Central Sensitization Inventory (mean \u00b1 SD, 53.3\u2009\u00b1\u200917.0 vs 42.7\u2009\u00b1\u200918.2; Cohen\u2019s d\u2009=\u20090.60, P &amp;lt; .001) but not with uterine tenderness or adenomyosis. Other clinical features associated with pain with orgasm were poorer sexual health (higher scores: deep dyspareunia, Cohen\u2019s h\u2009=\u20090.60; superficial dyspareunia, Cohen\u2019s h\u2009=\u20090.34; and Female Sexual Distress Scale\u2013Revised, Cohen\u2019s d\u2009=\u20090.68; all P &amp;lt; .05) and poorer mental health (higher scores: Patient Health Questionnaire\u20139, 12.9\u2009\u00b1\u20096.7 vs 9.1\u2009\u00b1\u20096.3, Cohen\u2019s d\u2009=\u20090.59, P &amp;lt; .001; Generalized Anxiety Disorder\u20137, 9.4\u2009\u00b1\u20095.6 vs 6.8\u2009\u00b1\u20095.5, Cohen\u2019s d\u2009=\u20090.48, P = .002). Anatomic findings at the time of surgery did not significantly differ between the groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Implications<\/jats:title>\n                  <jats:p>Interventions targeting pelvic floor myalgia and central nervous system sensitization may help alleviate pain worsened by orgasm in patients with endometriosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Strengths and Limitations<\/jats:title>\n                  <jats:p>A strength is that pain worsened by orgasm was differentiated from dyspareunia. However, pain with orgasm was assessed by only a binary question (yes\/no). Also, the study is limited to a single center, and there were limited data on sexual function.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Pelvic pain exacerbated by orgasm in people with endometriosis may be related to concurrent pelvic floor myalgia and central sensitization.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jsxmed\/qdae084","type":"journal-article","created":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T02:46:53Z","timestamp":1721702813000},"page":"807-815","source":"Crossref","is-referenced-by-count":7,"title":["Pain with orgasm in endometriosis: potential etiologic factors and clinical correlates"],"prefix":"10.1093","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1157-1170","authenticated-orcid":false,"given":"Avrilynn","family":"Ding","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of British Columbia , Vancouver V5H 3N1 , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Noga","sequence":"additional","affiliation":[{"name":"Women\u2019s Health Research Institute , Vancouver V5H 3N1 , Canada"},{"name":"Center for Pelvic Pain and Endometriosis, BC Women\u2019s Hospital , Vancouver V5H 3N1 , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9159-7663","authenticated-orcid":false,"given":"Katrina N","family":"Bouchard","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of British Columbia , Vancouver V5H 3N1 , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed A","family":"Bedaiwy","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of British Columbia , Vancouver V5H 3N1 , Canada"},{"name":"Center for Pelvic Pain and Endometriosis, BC Women\u2019s Hospital , Vancouver V5H 3N1 , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of British Columbia , Vancouver V5H 3N1 , Canada"},{"name":"Center for Pelvic Pain and Endometriosis, BC Women\u2019s Hospital , Vancouver V5H 3N1 , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Allaire","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of British Columbia , Vancouver V5H 3N1 , Canada"},{"name":"Center for Pelvic Pain and Endometriosis, BC Women\u2019s Hospital , Vancouver V5H 3N1 , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha L","family":"Orr","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of British Columbia , Vancouver V5H 3N1 , Canada"},{"name":"Center for Pelvic Pain and Endometriosis, BC Women\u2019s Hospital , Vancouver V5H 3N1 , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5521-3052","authenticated-orcid":false,"given":"Paul J","family":"Yong","sequence":"additional","affiliation":[{"name":"Women\u2019s Health Research Institute , Vancouver V5H 3N1 , Canada"},{"name":"Center for Pelvic Pain and Endometriosis, BC Women\u2019s Hospital , Vancouver V5H 3N1 , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,7,22]]},"reference":[{"issue":"13","key":"2024090406283359000_ref1","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1056\/NEJMra1810764","article-title":"Endometriosis","volume":"382","author":"Zondervan","year":"2020","journal-title":"N Engl J Med"},{"issue":"3","key":"2024090406283359000_ref2","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1007\/s13669-020-00288-8","article-title":"A proposed platform for phenotyping endometriosis-associated pain: unifying peripheral and central pain mechanisms","volume":"9","author":"Yong","year":"2020","journal-title":"Curr Obstet Gynecol Rep"},{"issue":"5","key":"2024090406283359000_ref3","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1093\/humupd\/dmu021","article-title":"Peripheral changes in endometriosis-associated pain","volume":"20","author":"Morotti","year":"2014","journal-title":"Hum Reprod Update"},{"issue":"5","key":"2024090406283359000_ref4","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1093\/humupd\/dmu025","article-title":"Central changes associated with chronic pelvic pain and endometriosis","volume":"20","author":"Brawn","year":"2014","journal-title":"Hum Reprod Update"},{"issue":"15","key":"2024090406283359000_ref5","doi-asserted-by":"crossref","first-page":"3203","DOI":"10.3390\/jcm10153203","article-title":"Nociplastic pain criteria or recognition of central sensitization? 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