Changes in quality of life after hormonal treatment of endometriosis.
BACKGROUND
To assess whether hormonal treatment of endometriosis improves quality of life for women with endometriosis.


METHODS
In a prospective, randomized, double-blind, double-dummy study on 48 women with verified endometriosis, the pain pattern and quality of life were registered before, during and after treatment with nafarelin or medroxyprogesterone acetate. The distribution of the studied parameters were tested by means of a Skewness test. ANOVA analysis was used for normally distributed variables and Friedman's analysis and Mann-Whitney U-test for non normally distributed variables.


RESULTS
There was a difference between the 30 women who participated all through the study and the 18 who dropped out. It was noticeable that anxiety-depression and sleep disturbances were significantly more common among the drop outs. There was a significant reduction in symptom score during the study, without any significant difference between the treatment groups. The sleep disturbances and anxiety-depression score improved significantly from before treatment to the end of the follow-up, but the anxiety-depression score increased during the nafarelin treatment period. There was a statistically significant improvement of paid working life in the nafarelin treated group. All the other psycho-social parameters as well as emotional balance improved during the study period without difference between groups.


CONCLUSIONS
When hormonal treatment is planned it is very important to take into consideration previous psychosocial experiences of the patient. Factors of importance for quality of life such as sleep disturbances and anxiety-depression improved significantly after treatment with nafarelin or medroxyprogesterone acetate.
Bergqvist
A
A
Department of Obstetrics and Gynecology, Huddinge University Hospital and Division of Psychosocial Factors and Health, Karolinska Institutet, Stockholm, Sweden.
Theorell
T
T
D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000209:etiology / Q000523:psychology; D003863:Depression / Q000209:etiology / Q000523:psychology; D004311:Double-Blind Method; D004715:Endometriosis / Q000150:complications / Q000188:drug therapy* / Q000523:psychology*; D005260:Female; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000627:therapeutic use*; D008875:Middle Aged; D017274:Nafarelin / Q000627:therapeutic use*; D010352:Patient Dropouts / Q000523:psychology; D017699:Pelvic Pain / Q000188:drug therapy / Q000209:etiology; D045167:Progesterone Congeners / Q000627:therapeutic use*; D011446:Prospective Studies; D011788:Quality of Life; D012893:Sleep Wake Disorders / Q000209:etiology / Q000523:psychology; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires
D045167:Progesterone Congeners; D017274:Nafarelin; D017258:Medroxyprogesterone Acetate