A Systematic Review of the Psychosocial Impact of Endometriosis before and after Treatment

While endometriosis is a common gynecologic disease associated with infertility, the psychosocial impact of endometriosis has not been evaluated against various quality of life (QoL) instruments and compared with other chronic illnesses. We rigorously analyzed the psychosocial burden of endometriosis in adult women and compared standardized and validated QoL scores of women with and without endometriosis, before and following treatment, and against other chronic illnesses. We searched PubMed, PsychINFO Embase, and Cochrane Reviews and ClinicalTrials.gov from January 1990 to December 2022 for publications using a detailed list of search terms related to QoL, endometriosis, and questionnaires. Only English-language publications that evaluated the association between Endometriosis and QoL using standardized and validated questionnaires measured at baseline and following treatment were considered. Four reviewers first performed a title and abstract screening followed by full text-review to finalize included articles. QoL scores of women with endometriosis were measured at baseline and analyzed against women without endometriosis and women with endometriosis who had undergone treatment. Additionally, baseline endometriosis scores were assessed against the published QoL scores of populations with other chronic conditions. Assessment of risk of bias was performed in accordance with Cochrane and Newcastle–Ottawa Scale guidelines. A total of 30 articles were included in this review: 4 randomized trials and 26 observational studies. The diagnosis and experience of women with symptomatic endometriosis had an equal or worse QoL score than that of other chronic conditions including heart disease, diabetes, and breast cancer when compared using the 36-Item Short Form Survey and World Health Organization Quality of Life questionnaires. Evidence showed association between low QoL and infertility, sexual dysfunction, mental health struggles, physical pain, poor sleep and fatigue. QoL scores were lower at baseline compared to following treatment in the majority of these domains. Endometriosis is associated with significant psychosocial burden and impaired QoL scores across baseline measurements in comparison to controls and other chronic illnesses. Medical and surgical interventions significantly decreased experienced burdens and improved QoL of women with endometriosis. Similar content being viewed by others Data Availability The data that support the findings of this study were derived from the following resources available in the public domain: PubMed, Embase, PsycINFO, and Cochrane Library databases. Code Availability N/A.

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Sleep quality and endometriosis: A group comparison study. J Endometriosis Pelvic Pain Disord. 2020;12(2):94–100. https://doi.org/10.1177/2284026520909979. Funding Supported by N.I.H. and N.I.C.H.D. grant R01 HD096147-01A1 to evaluate the role of cancer-associated mutations in endometriosis. Author information Authors and Affiliations Contributions AR, TR, VH, AL, AH and BS conceived of the presented idea and supervised the findings of this work. JB searched the databases for review articles for the research questions. AR, TR, VH, AL, AH, JS and BS interpreted the data and wrote the manuscript with help from JS and BS. All authors discussed the results and contributed to the final manuscript. Corresponding author Ethics declarations Ethics Approval N/A. Consent to participate N/A. Consent for publication N/A. Conflicts of Interest The authors report no conflicts of interest. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. About this article Cite this article Rempert, A.N., Rempert, T.H., Liu, A. et al. A Systematic Review of the Psychosocial Impact of Endometriosis before and after Treatment. Reprod. Sci. 31, 1828–1860 (2024). https://doi.org/10.1007/s43032-024-01515-w Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s43032-024-01515-w