Date of Award


Document Type


Degree Name

Master of Medicine (MMed)

First Supervisor/Advisor

DR Charles Muteshi

Second Supervisor/Advisor

DR Felix Oindi


AKU-East Africa


Introduction: Endometriosis is a benign, chronic condition that affects up to ten percent of women of childbearing age. It’s marked by the presence of endometrial tissue outside the uterine cavity (Giudice, 2010). It is a health condition with wide-ranging and pervasive sequelae making it a significant health concern requiring appropriate action (Rush & Misajon, 2018). We observed that there was a paucity of data relating to how endometriosis impacted on female sexual function and quality of life in sub-Saharan Africa, Kenya included.

Objectives: The primary goal of this empirical investigation was to determine the quality of life of women who had endometriosis at the Aga Khan University Hospital, Nairobi. The study also determined the female sexual function (using the Female Sexual Function Index (FSFI) Questionnaire) and personal sexual distress (using the Female Sexual Distress Scale-Revised [FSDS-R]) amongst the women with endometriosis and established whether there was an association between the FSFI and FSDS-R scores and quality of life of the participants.

Methods: A quantitative-based descriptive cross-sectional study design was used. This study was performed at the gynecology outpatient clinic of the Aga Khan University Hospital Nairobi among child-bearing age women (18-49 years) diagnosed with endometriosis during their clinics. Those eligible signed an informed consent form. The data collection tools included: a general demographic tool, the Short Form 36 Health Survey (SF-36), the Female Sexual Function Index Questionnaire (FSFI-Q), and the Female Sexual Distress Scale-Revised (FSDS-R), all of which were self-administered. With a count range of 0 to 100, the higher the tally on each domain of the SF-36, the more favorable was one’s quality of life status (Facchin et al., 2015; Giuliani et al., 2016). Overall scores of ≤ 26.55 on the FSFI-Q and an FSDS-R score ≥11 indicated impaired sexual functioning (Aydın et al., 2016; Nowosielski et al., 2013). Derived data was probed utilizing varied enumerations both descriptively and inferentially using SPSS version 25.0.

Results: The mean quality of life score among the study participants was 46% with 56.5% of the women having an aggregate SF-36 score of < 50%. The QoL domains with the lowest scores were general health and role functioning-emotional. Female sexual dysfunction (FSD) was observed in 76.9% of the participants. The sexual function domains with the lowest mean scores were arousal (mean = 2.74 ± 1.87), orgasm (mean = 2.8 ± 2.08), and pain (mean = 2.95± 2.33). The proportion of the women established to have female sexual distress was 65.7%. Both female sexual dysfunction and female sexual distress were found to have a notable association with poor quality of life in women with endometriosis as denoted by Logit regression p values of .018 and .012, respectively.

Conclusion: Women with endometriosis attending the Aga Khan University Hospital Nairobi had a less-than-desirable quality of life. A significant proportion of the women also had sexual dysfunction and sexual distress. Both sexual dysfunction and sexual distress were found to have a statistically significant association with low/poor quality of life in women with endometriosis