title: Endometriosis and perceived stress: impact of surgical and medical treatment.
abstract: BACKGROUND
  The aim of the study was to investigate the levels of perceived stress in a group of women with a long-term history of endometriosis in conjunction with surgical and/or medical treatments.
  
  
  METHODS
  A clinical trial was conducted at the Department of Molecular and Developmental Medicine, University of Siena, in collaboration with a non-profit association of women with endometriosis, A.P.E. Onlus. Patients (n = 204) with a previous diagnosis of endometriosis (for at least 3 years) were included in this study. Each patient completed a semi-structured questionnaire and a validated scale to assess perceived stress, the Perceived Stress Scale (PSS) by e-mail.
  
  
  RESULTS
  The study showed that in women with a long-term history of endometriosis, the level of perceived stress was increased by repeated surgical treatments and reduced by some medical treatments. The median PSS value was 23 (range 9-36) and 30.6% of the study population were included in the highest stress category (>26). The highest levels were found in patients who had undergone the most surgery. The use of progestins was associated with a lower perceived stress (p = 0.004) than in the patients treated with gonadotropin-releasing hormones.
  
  
  CONCLUSIONS
  Long-term endometriosis has a relevant impact on perceived stress, in particular in those undergoing repeated surgery.
authors.affiliation: Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Lazzeri
authors.forename: Cinzia
authors.initials: C
authors.lastname: Orlandini
authors.forename: Silvia
authors.initials: S
authors.lastname: Vannuccini
authors.forename: Serena
authors.initials: S
authors.lastname: Pinzauti
authors.forename: Claudia
authors.initials: C
authors.lastname: Tosti
authors.forename: Errico
authors.initials: E
authors.lastname: Zupi
authors.forename: Rosella Elena
authors.initials: RE
authors.lastname: Nappi
authors.forename: Felice
authors.initials: F
authors.lastname: Petraglia
mesh_terms: D000328:Adult; D015897:Comorbidity; D004715:Endometriosis / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000627:therapeutic use*; D013509:Gynecologic Surgical Procedures / Q000523:psychology*; D006801:Humans; D011372:Progestins / Q000627:therapeutic use*; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology*
chemical_list: D011372:Progestins; D007987:Gonadotropin-Releasing Hormone