The Impact of Endometriosis on the Quality of Life and the Incidence of Depression-A Cohort Study.

Damian Warzecha,Bronislawa Pietrzak,Iwona Szymusik,Miroslaw Wielgos

doi:10.3390/ijerph17103641

Abstract

The objective was to evaluate the quality of life and the incidence of depression among women suffering from endometriosis. Afterwards, the dependency between pelvic pain, its severity and stages of endometriosis were analyzed. The study protocol included women of reproductive ages with confirmed endometriosis. The stage of disease was conferred according to the ASRM (American Society of Reproductive Medicine) classification. Women fulfilled two questionnaires: “WERF EPHect Clinical Questionnaire” and self-prepared survey about fertility disorders. The study group comprised of 246 respondents. A total of 77.2% of women were symptomatic. The most common complaints were chronic pelvic pain (CPP, 71.1%), dysmenorrhea (69.0%) and dyspareunia (45.2%). Intensity of pain was independent from the stage of endometriosis. The incidence of infertility and the time to conceive increased with the stage of disease (stage 1—52.8%, 3.4 years; stage 2—66.7%, 4.1 years; stage 3—61.3%, 3.7 years; stage 4—96%, 6.1years; p = 0.02 and 0.03, respectively). The prevalence of depression was positively correlated with the beginning of dyspareunia (14.5 vs. 19.6 years old., p = 0.002). CPP (OR(odds ratio) = 3.8, 95% CI 1.2–12.8, p = 0.04) and painful defecation (OR = 7.7, 95% CI 1.4–42.3, p = 0.01) increased the risk of depression. Symptoms related to endometriosis and severity of pain correlate with the prevalence of depression. Stage of endometriosis is significantly related to the prevalence of infertility.

Highlights

Endometriosis is a chronic, inflammatory and disabling disease affecting many aspects of women’s lives
According to all of the above results, symptoms related to endometriosis poorly predict its stage
A total of 15.1% of women with endometriosis in the study group had been diagnosed with depression, to the findings presented by Fried et al who reported 14.5% incidence of depressive and 29% of anxiety symptoms among Austrian subjects suffering from endometriosis [28]

Summary

Introduction

Endometriosis is a chronic, inflammatory and disabling disease affecting many aspects of women’s lives. It is considered as one of the most common gynecological issues. Recent studies proved that endometriosis doubles the risk of infertility. Affected women usually present pelvic pain, dysmenorrhea, dyspareunia and infertility during their reproductive years [4]. The most useful clinical tool for staging of endometriosis is the classification introduced by American Society for Reproductive Medicine (ASRM) [5]. These stages do not sufficiently correlate with its clinical manifestation [6]

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Discussion

Conclusion