Department of Biology, Johns Hopkins University, Baltimore, MD, USA.
Department of Physiology and Biophysics, Casewestern Reserve University, Cleveland, OH, USA.
Reprod Sci. 2024 Jul;31(7):1828-1860. doi: 10.1007/s43032-024-01515-w. Epub 2024 Mar 21.
While endometriosis is a common gynecologic disease associated with infertility, the psychosocial impact of endometriosis has not been evaluated against various quality of life (QoL) instruments and compared with other chronic illnesses. We rigorously analyzed the psychosocial burden of endometriosis in adult women and compared standardized and validated QoL scores of women with and without endometriosis, before and following treatment, and against other chronic illnesses. We searched PubMed, PsychINFO Embase, and Cochrane Reviews and ClinicalTrials.gov from January 1990 to December 2022 for publications using a detailed list of search terms related to QoL, endometriosis, and questionnaires. Only English-language publications that evaluated the association between Endometriosis and QoL using standardized and validated questionnaires measured at baseline and following treatment were considered. Four reviewers first performed a title and abstract screening followed by full text-review to finalize included articles. QoL scores of women with endometriosis were measured at baseline and analyzed against women without endometriosis and women with endometriosis who had undergone treatment. Additionally, baseline endometriosis scores were assessed against the published QoL scores of populations with other chronic conditions. Assessment of risk of bias was performed in accordance with Cochrane and Newcastle-Ottawa Scale guidelines. A total of 30 articles were included in this review: 4 randomized trials and 26 observational studies. The diagnosis and experience of women with symptomatic endometriosis had an equal or worse QoL score than that of other chronic conditions including heart disease, diabetes, and breast cancer when compared using the 36-Item Short Form Survey and World Health Organization Quality of Life questionnaires. Evidence showed association between low QoL and infertility, sexual dysfunction, mental health struggles, physical pain, poor sleep and fatigue. QoL scores were lower at baseline compared to following treatment in the majority of these domains. Endometriosis is associated with significant psychosocial burden and impaired QoL scores across baseline measurements in comparison to controls and other chronic illnesses. Medical and surgical interventions significantly decreased experienced burdens and improved QoL of women with endometriosis.
虽然子宫内膜异位症是一种常见的与不孕相关的妇科疾病，但尚未针对各种生活质量 (QoL) 工具评估其对子宫内膜异位症的心理社会影响，并将其与其他慢性疾病进行比较。我们严格分析了成年女性子宫内膜异位症的心理社会负担，并比较了患有和未患有子宫内膜异位症的女性在治疗前后的标准化和验证后的 QoL 评分，并与其他慢性疾病进行了比较。我们从 1990 年 1 月至 2022 年 12 月在 PubMed、PsychINFO Embase 和 Cochrane Reviews 和 ClinicalTrials.gov 上搜索了使用与 QoL、子宫内膜异位症和问卷相关的详细搜索词列表的出版物。只有使用标准化和验证后的问卷评估子宫内膜异位症与 QoL 之间关联，并在基线和治疗后进行测量的英文出版物才被认为是符合条件的。四名评审员首先进行了标题和摘要筛选，然后进行全文审查以确定纳入的文章。患有子宫内膜异位症的女性的 QoL 评分在基线时进行测量，并与没有子宫内膜异位症的女性和接受治疗的患有子宫内膜异位症的女性进行比较。此外，还评估了基线子宫内膜异位症评分与其他慢性疾病人群的已发表 QoL 评分。根据 Cochrane 和纽卡斯尔-渥太华量表指南评估偏倚风险。本综述共纳入 30 篇文章：4 项随机试验和 26 项观察性研究。与心脏病、糖尿病和乳腺癌等其他慢性疾病相比，使用 36 项简短健康调查问卷和世界卫生组织生活质量调查问卷时，有症状的子宫内膜异位症女性的诊断和患病经历的生活质量评分相等或更差。有证据表明，低生活质量与不孕、性功能障碍、心理健康问题、身体疼痛、睡眠和疲劳不佳有关。在这些领域中，大多数情况下，基线时的 QoL 评分低于治疗后。与对照组和其他慢性疾病相比，子宫内膜异位症在基线测量时就与显著的心理社会负担和受损的生活质量评分相关。医疗和手术干预显著降低了患有子宫内膜异位症的女性的负担，并改善了她们的生活质量。
