Pain, Fertility, and Mental Health: The Burden of Endometriosis on Quality of Life

RESUME INTRODUCTION Endometriosis is a chronic gynecological condition that significantly affects quality of life due to its association with chronic pelvic pain, infertility, and psychological distress. The complexity of its pathophysiology, combined with frequent delays in diagnosis, leads to prolonged suffering and an increased burden on healthcare systems. Beyond physical symptoms, endometriosis has substantial socioeconomic implications, affecting work productivity, social interactions, and mental well-being. Despite its high prevalence, many patients struggle with inadequate symptom control and limited access to specialized care, highlighting the need for a more comprehensive approach to management. OBJETIVE To evaluate the impact of endometriosis on quality of life, including physical, psychological, reproductive, and social aspects, and to assess current treatment strategies aimed at improving patient outcomes. METHODS This is a narrative review which included studies in the MEDLINE – PubMed (National Library of Medicine, National Institutes of Health), COCHRANE, EMBASE and Google Scholar databases, using as descriptors: “Endometriosis” OR “Chronic pain” OR” Infertility” OR “Mental health” OR “Quality of life” in the last years. RESULTS AND DISCUSSION The results indicate that pain intensity and disease burden are not always correlated with disease stage, making symptom-based management crucial. Pharmacological treatments, including hormonal therapies, provide varying degrees of relief, but long-term side effects often limit their use. Surgical excision improves symptom control but is associated with high recurrence rates. Infertility remains a major concern, requiring individualized fertility-preserving strategies. Psychological distress, including anxiety and depression, is common among patients, underscoring the need for mental health support. Holistic approaches, such as dietary modifications, pelvic floor therapy, and complementary medicine, show promise as adjunctive therapies in improving symptom management. CONCLUSION Addressing the impact of endometriosis on quality of life requires an integrative and patient-centered approach that combines early diagnosis, personalized treatment, and multidisciplinary care. Research on novel pharmacological agents, alternative therapies, and healthcare policy improvements will be essential to optimize patient outcomes. Greater awareness and advocacy efforts are needed to reduce diagnostic delays, improve treatment accessibility, and ultimately enhance the well-being of individuals living with endometriosis.