The effects of endometriosis on life satisfaction.

How catastrophic is endometriosis on women’s well-being?

Key Points

Highlights:

• Women with endometriosis are under the pressure of physical, psychosocial, social, sexual, and obstetrical problems.

Importance:

• The social, sexual, physical, and reproductive life of endometriosis patients is devastated and more research is necessary to clarify a better understanding of endometriosis complications to make life easier for those women.

What's done here:

• Databases including PubMed, Science Direct, Scopus, and Google scholar have been searched in order to identify the articles regarding reproductive health in women with endometriosis.
• Overall, 2850 studies were extracted. But finally, 46 articles fulfilling the inclusion criteria were analyzed.
• The sections including the pathogenesis of endometriosis, Physical impact, Psychological impact, Social impact, Sexual impact, and Obstetrical impact have been summarized from the search.

Key Results:

• The pathogenesis theories have been summarized in 3 groups: i) implants arise from the endometrium (Sampson’s theory), ii) implants originate from tissues at other sites (coelomic metaplasia and induction theory), and, iii) the genetic theory; to try to explain the different types and different therapy responses.
• The physical impact analysis revealed that the patients with endometriosis suffer from different types of pain, ranging from pelvic pain to headaches, and also from comorbidities (rheumatologic diseases, cancer, and side effects of medical and/or surgical therapies) that affect the physical wellbeing.
• The overall results from studies questioning the social life of the endometriosis patients revealed that the pain and other associated symptoms of endometriosis cause impairment in the social and work life of women.
• Endometriosis-related sexual pain was found to affect the desire, satisfaction, and functioning of sexual life causing increased tension and verbal conflict with the partner, feelings of guilt towards the spouse, and feeling less of a woman.
• The obstetrical outcomes revealed an increased risk for a variety of prenatal, natal, and perinatal complications.

Limitations:

• The majority of papers were collected from high-income countries with developed healthcare systems which limits the value of the study to reflect all women from all around the world and their needs.

Lay Summary

Endometriosis is well-known for its debilitating effects on women suffering from it.

In the review conducted by Masoumeh Namazi et al, the authors have collected studies searching for the wellbeing of women with endometriosis. They have analyzed 46 studies that covered their inclusion criteria. Following the selection, the articles have undergone sectioning for pathogenesis, and the effects of endometriosis on the sexual, physical, physiological, and social life of women. Finally, the obstetrical outcome and related problems of the women with endometriosis were grouped.

The results revealed that the social life of endometriosis patients is devastated in both family issues and work partners.

The sexual wellbeing of women with endometriosis is affected by the presence of dyspareunia which in the long run cause problems with the spouse.

The physical changes caused by either the disease itself or the side effects of the therapies cause the women disabilities which again withdraws the women from active daily life.

Not only infertility is a big problem in the life of these women, the obstetrical complications coming after a huge effort to get pregnant remain complicated and those pregnancies have to be closely monitored.

The authors concluded that "Even the study covered part of the world it has to be acknowledged that women with endometriosis suffer from different aspects and more research is needed to clarify a better understanding of endometriosis complications to make life easier for those women".

This article is recently published in the "Journal of Obstetrics and Gynecology".

Research Source: https://pubmed.ncbi.nlm.nih.gov/33645413/