Effect of noncancerous pelvic problems on health-related quality of life and sexual functioning.
OBJECTIVE
To assess the effect of abnormal uterine bleeding and pelvic pain and pressure on health-related quality of life and sexual functioning and assess treatment satisfaction.


METHODS
This is a cross-sectional study of 1,493 sociodemographically diverse women who were seeking care for noncancerous pelvic problems and who had not undergone hysterectomy. Participants were asked about symptoms, attitudes, health-related quality of life, sexual functioning, and treatment satisfaction. Preference for current health was measured using the time tradeoff metric, which asked respondents to estimate the number of years of life they would be willing to trade off to not have a uterine condition. Multivariable logistic regression was used to identify determinants of treatment satisfaction.


RESULTS
Most (82.7%) participants reported a complete lack of or only partial symptom resolution, and 42.3% reported that their pelvic problems interfered with their ability to have and enjoy sex. Mean Short Form-12 Physical (43-49) and Mental (41-44) Component Summary scores were substantially lower than population norms for women aged 40-49 years. Mean current health time tradeoff scores ranged from 0.78 to 0.88. Satisfaction with Western medicines ranged from 31.3% (progestin intrauterine device) to 58.2% (opiates) and with uterine-preserving surgery from 20.0% (dilation and curettage) to 51.0% (myomectomy); 27.7 % of the women who used acupuncture were satisfied. Participants with lower educational attainment, greater symptom resolution, and less interference of pelvic problems with sex were more likely to be satisfied.


CONCLUSIONS
Noncancerous pelvic problems are associated with serious decrements in health-related quality of life and sexual functioning and low rates of treatment satisfaction.


METHODS
II.
Kuppermann
Miriam
M
Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, California 94143-0856, USA. kuppermannm@obgyn.ucsf.edu
Learman
Lee A
LA
Schembri
Michael
M
Gregorich
Steven
S
Jacoby
Alison
A
Jackson
Rebecca A
RA
Gates
Elena
E
Wassel-Fyr
Christina
C
Lewis
James
J
Washington
A Eugene
AE
D000328:Adult; D002140:California / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D017060:Patient Satisfaction; D017699:Pelvic Pain / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D011787:Quality of Health Care; D011788:Quality of Life; D012725:Sexual Behavior / Q000502:physiology*; D018434:Sickness Impact Profile; D014592:Uterine Hemorrhage / Q000150:complications* / Q000453:epidemiology / Q000523:psychology