Quality of Life in Women with Endometriosis

Impact of endometriosis on Quality of Life (QoL) and general well-being.

Key Points

Highlights:

• Endometriosis is a chronic disease that affects many aspects of physical, mental, and emotional well being. Women with endometriosis had worse QoL than healthy women in several domains of their lives which should be assessed in each patient when treating endometriosis as a chronic disease with real implications on daily living and well-being.

Importance:

• This study was conducted to review the current health-related quality of life (QoL) data on women with endometriosis and to highlight its diverse impact on QoL.

 Key Points:

• Twenty-six articles were included in this study’s analysis. Nine out of the twenty-six articles used a validated QoL questionnaire system for assessing the physical, psychological, general health, social functioning, and emotional state of patients. 
• Two studies included in the assessment measured perceived stress and compared it to mental health-related QoL. Additionally, a physical activity and sleep quality questionnaire were administered in separate studies. Studies that observed QoL scores, for the most part, found a significant difference in these aspects of daily living.
• Significant differences between women with endometriosis and controls were observed
• The physical functioning domain in three articles; bodily pain in three, social functioning in two, mental health in three, general health perceptions in four, and vitality in four articles.
• Perceived stress was significantly higher in women with endometriosis. Within the physical activity domain, one study showed that women with endometriosis had lower activity levels than women without endometriosis. Regarding sleep quality, higher pain scores in women with endometriosis correlated with a reduced sleep quality score.
• Domains affected by endometriosis were studied were variable between studies, but pain and physical components of the QoL were a significant issue.

 Limitations:

• Several different questionnaires were used to assess QoL within each study. Because of this, QoL scores were not always affected in a homogeneous manner.

Lay Summary

Endometriosis is a chronic disease characterized by the presence of endometrial tissue outside the uterine cavity. Progression and spread of the disease to other structures may lead to symptoms such as pelvic pain, urinary, and GI dysfunction. Endometriosis has been seen to affect multiple aspects of a woman’s life that are included in the QoL construct. Thus, QoL is an important indicator of what other features of endometriosis’ effects on health need to be addressed.

Twenty-six articles were included in this study’s analysis. Nine out of the twenty-six articles used a validated QoL questionnaire system for assessing the physical, psychological, general health, social functioning, and emotional state of patients. Scores are on a 0-100 scale. Two studies included in the assessment measured perceived stress and compared it to mental health-related QoL. Additionally, a physical activity and sleep quality questionnaire were administered in separate studies. Studies that observed QoL scores, for the most part, found a significant difference in these aspects of daily living. Interestingly, one of these studies found that only dysmenorrhea was negatively correlated with physical, social, and environmental domains of the QoL score. However, another study found that endometriosis significantly reduced psychological and ecological domain scores within the QoL assessment. Perceived stress was significantly higher in women with endometriosis than in women without endometriosis. Within the physical activity domain, one study showed that women with endometriosis had lower activity levels than women without endometriosis. Regarding sleep quality, higher pain scores in women with endometriosis correlated with a reduced sleep quality score.

Thus, women with endometriosis had worse QoL than healthy women in several domains of their lives. As such, these aspects of QoL should be assessed in each patient when treating endometriosis as a chronic disease with real implications on daily living and well-being.

Research Source: https://www.ncbi.nlm.nih.gov/pubmed/29064316