Quality of Life and Psychological Comorbidities in Endometriosis and Adenomyosis: A Prospective Observational Study Using Advanced Ultrasound

Richard E, Evelyne Richard, E. Richard, Madeleine Lemyre, Lemyre M, Arendas K, Kristina Arendas, Maheux-Lacroix S, Sarah Maheux-Lacroix, Sarah Maheux‐Lacroix
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC · 2026 · vol. 48(10) , pp. 103482 · doi:10.1016/j.jogc.2026.103482 · PMID:42532472 · W7171873990
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Advanced ultrasound diagnosis of endometriosis or adenomyosis did not significantly affect quality of life, which was instead strongly influenced by anxiety, depression, pain catastrophizing, central sensitization, and dysmenorrhea.

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Abstract

OBJECTIVES: This study aimed to assess whether the presence of endometriosis and/or adenomyosis on advanced ultrasound accounts for variations in quality of life. Our secondary objective was to examine potential determinants of quality of life in this population. METHODS: This prospective observational study was conducted at a tertiary referral centre for pelvic pain (Laval University Hospital Center, Canada) from March 2021 to December 2024. Premenopausal patients aged ≥18 years with pelvic pain in the presence of endometriotic and/or adenomyotic lesions diagnosed by advanced ultrasound were included. Data were collected via questionnaires and validated tools, including the EPHect Patient Questionnaire, Endometriosis Health Profile-30, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, and others. RESULTS: Of the 180 eligible participants, 43% (77/180) had endometriosis, 19% (34/180) had adenomyosis, and 38% (69/180) had both. No significant differences were observed in quality of life between groups (Endometriosis Health Profile-30 mean: 53.1 ± 26.4, P = 0.82). Analysis of quality of life revealed that anxiety (β = 17.6), depression (β = 14.7), pain catastrophizing (β = 10.3), central sensitization (β = 8.3), and dysmenorrhea (β = 8.1) were the main determinants of quality of life. Dyschezia (β = 5.5), absence of a diagnosis before ultrasound (β = 4.6), dyspareunia (β = 4.2), and chronic pelvic pain (β = 4.1) were also significant determinants. CONCLUSIONS: The presence of adenomyosis, endometriosis, or both on advanced ultrasound fails to explain variations in quality of life in patients with pelvic pain. Anxiety, depression, pain catastrophizing, central sensitization, and dysmenorrhea seem to be important factors affecting quality of life. These results highlight the complex interplay of psychological and physical factors in determining quality of life in patients with endometriosis and/or adenomyosis.

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MeSH descriptors

Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Quality of Life Quality of Life Quality of Life Adult Adult Anxiety Anxiety Anxiety Comorbidity Comorbidity

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (27)

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