Grant: Operating Grant

Endometriosis is present in up to 1 of 10 reproductive-aged women, 5 of 10 women with infertility, and 5 of 10 women with pelvic pain. It is defined as tissue normally inside the uterus (womb), being abnormally present outside of the uterus, typically elsewhere in the pelvis. Endometriosis is responsible for $1.8 billion in total annual costs to Canadian society due to its impact on women's fertility and pain. In particular, endometriosis causes pelvic pain with intercourse/penetration during sexual activity, which is known as dyspareunia. Half of women with endometriosis experience dyspareunia, which reduces women's sexual activity, sexual satisfaction, self-esteem, and quality-of-life. Partners of women with endometriosis also describe depression, anxiety, powerlessness, and grief. Dyspareunia is one of the most difficult clinical problems to manage in endometriosis, primarily because how endometriosis causes dyspareunia is largely unknown. Our objective is to identify the causes of dyspareunia in endometriosis. We propose that dyspareunia in endometriosis is caused by abnormalities in multiple body systems, such as depression, a painful bladder and painful pelvic floor musculature, an increase in nerves around endometriosis, and genetic changes. This research will produce a significant change in how we understand endometriosis. It will provide a holistic model for how endometriosis leads to pain (such as dyspareunia) that involves the whole person, ranging from psychological, anatomic, cellular, and genetic factors. This will help women with endometriosis to understand the different reasons why sex may be painful, and will help clinicians and researchers to better treat this pain.