Women with moderate-to-severe endometriosis have a lower health-related quality of life compared with women from the general population, researchers in Norway report.
And, compared to patients with rheumatoid arthritis — another chronic and painful inflammatory disease, and one that mostly affects women — their mental health tends to be poorer, possibly because of endometriosis-linked problems with fertility among women who do not have children.
These findings are in the study “Health‐related quality of life in women with endometriosis, compared to the general population and women with rheumatoid arthritis,” published in the journal Acta Obstetricia et Gynecologica Scandinavica.
Researchers aimed to compare the impact of endometriosis in the health-related quality of life of women, compared to both women from the general population and those with rheumatoid arthritis.
Their intent was to gain a better understanding of the disease burden endometriosis places on patients.
Prior studies have indicated that health-related quality of life is negatively affected by the condition, but comparisons with the general population or people with similar conditions, such as rheumatoid arthritis, are lacking.
The cross-sectional study included 157 women with endometriosis, 156 from the general population, and 837 with rheumatoid arthritis.
Endometriosis patients, ages 18 to 45, were recruited from the Norwegian Endometriosis Association and from a random sample of women residing in Oslo. Data on women with rheumatoid arthritis was taken from the Oslo Rheumatoid Arthritis Register.
Health-related quality of life in all groups was evaluated through the questionnaire Short Form-36 (SF-36), a well-established health survey. It uses eight scales to assess different dimensions of life quality, including physical and mental well-being.
Overall, women with endometriosis had significantly lower health-related quality of life scores compared to the general population, even after adjusting for age, body mass index, and infertility.
Endometriosis also impacted quality of life more strongly than rheumatoid arthritis, significantly in the areas of vitality, social functioning, and mental health. Mean bodily pain scores were similar between these patient groups, the study noted.
Life quality between endometriosis patients who were infertile, and those who were not, was found to be similar.
However, infertile patients without children reported poorer social functioning and mental health, and greater limitations on their roles in life due to emotional problems, suggesting that combination of childlessness and infertility, more than infertility per se, affected their mental health.
Results also implied that pain affects mental health differently in women with endometriosis and rheumatoid arthritis. Pain associated with endometriosis seems to significantly impact mental well-being, possibly due to psychological stress (anxiety, depression, and distress).
“Endometriosis tends to occur at an earlier age than RA [rheumatoid arthritis], hitting women from the onset of fertility and during a formative stage when it comes to identity, career, relationships, and family,” the researchers concluded. “RA, on the other hand, hits women mainly at the post-fertile stage. The indirect consequences associated with endometriosis may therefore be different and cause psychological stress not associated with RA.”