Impact of endometriosis on quality of life and mental health: pelvic pain makes the difference.
BACKGROUND
No prior study of endometriosis has investigated the psychological impact of having asymptomatic endometriosis versus endometriosis with pelvic pain in a systematic way. This study aimed at examining the impact of endometriosis on quality of life, anxiety and depression by comparing asymptomatic endometriosis, endometriosis with pelvic pain, and healthy, pain-free controls. The psychological impact of different types of endometriosis pain was also tested.


METHODS
One hundred and ten patients with surgically diagnosed endometriosis (78 with pelvic pain and 32 without pain symptoms) and 61 healthy controls completed two psychometric tests assessing quality of life, anxiety and depression. Endometriosis participants indicated on a numerical rating scale the intensity of four types of pain (dysmenorrhea, dyspareunia, non-menstrual pelvic pain and dyschezia).


RESULTS
Endometriosis patients with pelvic pain had poorer quality of life and mental health as compared with those with asymptomatic endometriosis and the healthy controls. No significant differences were found between asymptomatic endometriosis and the control group. Dysmenorrhea had significant effects only on physical quality of life; non-menstrual pelvic pain affected all the variables; no significant effects were found for dyspareunia and dyschezia.


CONCLUSIONS
Pain significantly affects women's experience of endometriosis. The medical treatment of endometriosis with pain may not be sufficient and psychological intervention is recommended.
a Department of Psychology , Catholic University of Milan , Milan , Italy .
Federica
F
Facchin
b Department of Obstetrics and Gynecology , Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico and Università degli Studi di Milano , Milano , Italy , and.
Giussy
G
Barbara
a Department of Psychology , Catholic University of Milan , Milan , Italy .
Emanuela
E
Saita
c Department of Public Health , IRCCS - Istituto Mario Negri , Milano , Italy.
Paola
P
Mosconi
c Department of Public Health , IRCCS - Istituto Mario Negri , Milano , Italy.
Anna
A
Roberto
b Department of Obstetrics and Gynecology , Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico and Università degli Studi di Milano , Milano , Italy , and.
Luigi
L
Fedele
b Department of Obstetrics and Gynecology , Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico and Università degli Studi di Milano , Milano , Italy , and.
Paolo
P
Vercellini
D000328:Adult; D001007:Anxiety / Q000209:etiology / Q000503:physiopathology; D003248:Constipation / Q000209:etiology / Q000503:physiopathology; D003627:Data Interpretation, Statistical; D003863:Depression / Q000209:etiology / Q000503:physiopathology; D004412:Dysmenorrhea / Q000209:etiology / Q000523:psychology; D004414:Dyspareunia / Q000209:etiology / Q000523:psychology; D004715:Endometriosis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006801:Humans; D007558:Italy; D008603:Mental Health / Q000706:statistics & numerical data; D010147:Pain Measurement / Q000379:methods; D017699:Pelvic Pain / Q000209:etiology / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics / Q000379:methods; D011788:Quality of Life
Anxiety; depression; endometriosis; pelvic pain; quality of life