No difference in anxiety symptoms between women with unilateral and bilateral ovarian endometriosis: a prospective cross-sectional study

OBJECTIVE: This study aimed to investigate whether women with unilateral and bilateral OMA differ in anxiety symptoms, and secondarily in depressive symptoms and sexual dysfunction symptoms, and to evaluate the independent contribution of chronic pelvic pain to psychological outcomes. STUDY DESIGN: This study, a prospective, cross-sectional study, included 149 women aged 20-35 who had OMA but were not pregnant and had a desire to become pregnant. There were 79 women with unilateral OMA and 70 women with bilateral. The Zung Self-Rating Anxiety Scale, Self-Rating Depression Scale, and Female Sexual Function Index were administered at enrolment. Multivariable linear regression models were adjusted for age, BMI, chronic pelvic pain, dysmenorrhoea, primary infertility, and medication use. Post-hoc power analysis was performed. RESULT: The average age of the patients was 27.45 ± 3.44, with an average BMI of 19.46 ± 2.28. 29.53%(44/149) of the patients had mild or moderate anxiety, while 38.92%(57/149) had mild or moderate depression. Among the 103 patients with a history of sexual activity, 67.96%(70/103) had sexual dysfunction. In multivariable analyses, cyst laterality was not significantly associated with anxiety symptoms (adjusted B = -2.58[-5.19, 0.03], p = 0.052), depressive symptoms (adjusted B = -1.86[-5.25, 1.53], p = 0.279), or sexual dysfunction symptoms (adjusted B = -0.91[-2.01, 0.19], p = 0.072). Chronic pelvic pain independently predicted anxiety symptoms (p = 0.01) and depressive symptoms (p = 0.025). Post-hoc power analysis indicated an achieved power of 50% for the primary SAS comparison. CONCLUSION: In this study, the prevalence of anxiety, depression and sexual dysfunction was high in OMA, but there was no significant difference between unilateral and bilateral OMA. Chronic pelvic pain, rather than cyst laterality, independently predicted psychological distress. These findings underscore the importance of comprehensive pain assessment and routine psychological screening for all women with OMA.