Effect of Endometriosis Pain in Women Living in Similar Socio-Economic Conditions

Pelvic pain due to endometriosis has a negative effect on the health-related quality of life of American and European women, study shows.

Key Points

Highlights: 

• Endometriosis-associated pelvic pain is linked to reduced health-related quality of life among women living in similar socio-economic conditions.

Importance:

• Finding ways to reduce endometriosis-associated pelvic pain is very important for endometriosis patients.

What’s done here:

• Researchers conducted a systematic review and meta-analysis of the literature of studies conducted in France, Germany, Italy, Spain, the UK, and the US between 2013 and 2022.

Key results:

• There was an association between endometriosis-associated pelvic pain and reduced health-related quality of life.
• Endometriosis-associated pelvic pain was associated with lower health-related quality of life compared to endometriosis without pain.
• There was a potential association between reduced health-related quality of life and chronic pelvic pain due to other conditions.
• Endometriosis-associated pelvic pain had a detrimental effect on general health-related quality of life as well as mental health functioning and sexual functioning and led to a reduction in work productivity and daily activity performance.
• The detrimental effects were similar in adolescents, young women, and older women. 

Limitations:

• The causal relationship between endometriosis and pelvic pain cannot be established.
• The effect of dyschezia (pain during defecation) and pain during ovulation were not identified and its effect on health-related quality of life was not investigated.

Lay Summary

Endometriosis-associated pelvic pain is associated with reduced health-related quality of life including impaired mental and sexual functioning among women in France, Germany, Italy, Spain, the UK, and the US, according to a new study published in the Journal of Minimally Invasive Gynecology. It is also associated with reduced work performance and productivity. 

According to the study authors, each of the above “may contribute to the societal burden of endometriosis”. The study aimed to assess the burden of endometriosis-associated pelvic pain on health-related quality of life in women living under similar socio-economic conditions.

The team led by Dr. Martin Merz from Bayer Pharma AG in Berlin, Germany conducted a systemic review and meta-analysis of the literature for studies published between 2013 and 2022 and analyzed 27 eligible studies; more than half (14) were from Italy, 4 were from the US, 3 were from Spain, and 1 was from Germany. There were also 5 multinational studies. The majority of studies (56%) were cross-sectional, 26% were case-control, 11% were cohort, and only 7% were longitudinal. 

The results showed that there was an association between endometriosis-associated pelvic pain and reduced health-related quality of life. Moreover, many studies showed that endometriosis-associated pelvic pain was linked to lower health-related quality of life compared to endometriosis without pain. There was also a potential association between reduced health-related quality of life and chronic pelvic pain due to other conditions. However, the evidence was limited in this case. 

The studies also showed that endometriosis-associated pelvic pain had detrimental effects not only on general health-related quality of life but also on mental health functioning and sexual functioning. All these led to a reduction in productivity at work and difficulties in performing everyday tasks.  The associations reported were usually similar between different populations and age groups including adolescents, younger women, and older women. 

“The existing literature suggests that, among women in selected European countries and the United States, [endometriosis-associated pelvic pain] is associated with reduced [health-related quality of life],” the authors concluded. They said that more research is needed into ways of reducing the burden of endometriosis-associated pelvic pain, which can in turn improve women’s health-related quality of life.

Research Source: https://pubmed.ncbi.nlm.nih.gov/38729420/