Impact of endometriosis on quality of life and mental health: pelvic pain makes the difference

TLDR

Previous research has not systematically examined the psychological impact of asymptomatic versus painful endometriosis. The study compared quality of life, anxiety, and depression among asymptomatic endometriosis patients, painful endometriosis patients, and healthy controls. The authors recruited 110 surgically confirmed endometriosis patients (78 with pelvic pain, 32 asymptomatic) and 61 healthy controls, who completed psychometric tests of quality of life, anxiety, and depression, and rated pain intensity for four pain types. Patients with pelvic pain reported significantly worse quality of life and mental health than asymptomatic patients and controls, whereas asymptomatic patients did not.

Abstract

Introduction: No prior study of endometriosis has investigated the psychological impact of having asymptomatic endometriosis versus endometriosis with pelvic pain in a systematic way. This study aimed at examining the impact of endometriosis on quality of life, anxiety and depression by comparing asymptomatic endometriosis, endometriosis with pelvic pain, and healthy, pain-free controls. The psychological impact of different types of endometriosis pain was also tested.Methods: One hundred and ten patients with surgically diagnosed endometriosis (78 with pelvic pain and 32 without pain symptoms) and 61 healthy controls completed two psychometric tests assessing quality of life, anxiety and depression. Endometriosis participants indicated on a numerical rating scale the intensity of four types of pain (dysmenorrhea, dyspareunia, non-menstrual pelvic pain and dyschezia).Results: Endometriosis patients with pelvic pain had poorer quality of life and mental health as compared with those with asymptomatic endometriosis and the healthy controls. No significant differences were found between asymptomatic endometriosis and the control group. Dysmenorrhea had significant effects only on physical quality of life; non-menstrual pelvic pain affected all the variables; no significant effects were found for dyspareunia and dyschezia.Conclusions: Pain significantly affects women's experience of endometriosis. The medical treatment of endometriosis with pain may not be sufficient and psychological intervention is recommended.