- Behzad Ghorbani
 - - Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
- Farhad Yaghmaie
- - Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
Received: 11/9/2008 Accepted: 3/10/2009 - Publisher : Avicenna Research Institute |
| Related Articles |
|
| Other Format |
|
|
|
Abstract
Introduction: Endometriosis is a chronic gynaecological disease with a prevalence of about 10% in women of reproductive age. The typical symptoms of this disease include chronic pelvic pain, dyspareunia and infertility with an overall negative impact on the psychosocial parameters in the subjects, leading to a significant reduction of quality of life. Health-Related Quality of Life (HRQL) is a multi-dimensional, dynamic concept that encompasses physical, psychological and social aspects of individuals. The aim of this study was to evaluate quality of life in patients with endometriosis. Materials and Methods: This descriptive, cross-sectional study was performed on forty 22–28 year-old women with endometriosis, attending Avicenna Infertility Clinic and Shahid Beheshti University of Medical Sciences. Endometriosis Health Profile-5 (EHP-5) questionnaire was used in interviews to collect data from individuals willing to participate in the study. Results: The mean age of participants was 35.7±8.3 years with an average duration of the disease of 32 months (6 to 84 months). All the patients were infertile, 75% suffered from dyspareunia and 32% had painful walking. Functional impairment was seen in 62% of the individuals and 92% felt as though symptoms were ruling their lives. Mood swing was seen in 55% of the patients, 37% felt depressed and 34% thought their general appearance had been affected. About 73% believed that healthy individuals and 41% believed that even medical doctors did not realize the gravity of their disease, while 29% felt hopeless because of treatment effectiveness.Conclusion: Endometriosis impairs quality of life, specially in the domains of pain, psychological and functional abilities. Although, medical and surgical measurements improve physical and psychological functions, increase energy levels and lessen pain but psychotherapy and appropriate pharmacotherapy seem to be essential in the management of endometriosis.
Keywords:
Chronic pelvic pain, Dyspareunia, EHP-5 questionnaire, Endometriosis, Infertility, Quality of life To cite this article:References
- Olive DL, Schwartz LB. Endometriosis. N Engl J Med. 1993;328(24):1759-69.
- Jones G, Jenkinson C, Taylor N, Mills A, Kennedy S. Measuring quality of life in women with endometrio-sis: tests of data quality, score reliability, response rate and scaling assumptions of the Endometriosis Health Profile Questionnaire. Hum Reprod. 2006;21(10): 2686-93. [PubMed]
- Winkel CA. Evaluation and management of women with endometriosis. Obstet Gynecol. 2003;102(2):397-408. Review. [PubMed]
- Gazvani R, Templeton A. New considerations for the pathogenesis of endometriosis. Int J Gynaecol Obstet. 2002;76(2):117-26. Review. [PubMed]
- Revised American Society for Reproductive Medicine classification of endometriosis: 1996. Fertil Steril. 1997;67(5):817-21. [PubMed]
- Missmer SA, Cramer DW. The epidemiology of endo-metriosis. Obstet Gynecol Clin North Am. 2003; 30(1): 1-19. Review. [PubMed]
- Coste J, Guillemin F, Pouchot J, Fermanian J. Method-ological approaches to shortening composite measure-ment scales. J Clin Epidemiol. 1997;50(3):247-52. [PubMed]
- Zondervan K, Barlow DH. Epidemiology of chronic pelvic pain. Baillieres Best Pract Res Clin Obstet Gynaecol. 2000;14(3):403-14. Review. [PubMed]
- Low WY, Edelmann RJ, Sutton C. A psychological profile of endometriosis patients in comparison to patients with pelvic pain of other origins. J Psychosom Res. 1993;37(2):111-6. [PubMed]
- Gambone JC, Mittman BS, Munro MG, Scialli AR, Winkel CA, Chronic Pelvic Pain/Endometriosis Work-ing Group. Consensus statement for the management of chronic pelvic pain and endometriosis: proceedings of an expert-panel consensus process. Fertil Steril. 2002; 78(5):961-72. [PubMed]
- Levine S. The changing terrains in medical sociology: emergent concern with quality of life. J Health Soc Behav. 1987;28(1):1-6. [PubMed]
- Wilson IB, Cleary PD. Linking clinical variables with health-related quality of life. A conceptual model of patient outcomes. JAMA. 1995;273(1):59-65. [PubMed]
- Jones G, Jenkinson C, Kennedy S. Evaluating the responsiveness of the Endometriosis Health Profile Questionnaire: the EHP-30. Qual Life Res. 2004;13(3): 705-13. [PubMed]
- Mathias SD, Kuppermann M, Liberman RF, Lipschutz RC, Steege JF. Chronic pelvic pain: prevalence, health-related quality of life and economic correlates. Obstet Gynecol. 1996;87(3):321-7. [PubMed]
- Peveler R, Edwards J, Daddow J, Thomas E. Psy-chosocial factors and chronic pelvic pain: a comparison of women with endometriosis and with unexplained pain. J Psychosom Res. 1996;40(3):305-15. [PubMed]
- Denny E. Women`s experience of endometriosis. J Adv Nurs. 2004;46(6):641-8. [PubMed]
- Talor EM. The stress of infertility. Hum Ecol. 2002;95 (1):12.
- Colwell HH, Mathias SD, Pasta DJ, Henning JM, Steege JF. A health-related quality-of-life instrument for symptomatic patients with endometriosis: a valid-ation study. Am J Obstet Gynecol. 1998;179(1):47-55. [PubMed]
- Jones G, Kennedy S, Barnard A, Wong J, Jenkinson C. Development of an endometriosis quality-of-life instrument: The Endometriosis Health Profile-30. Obstet Gynecol. 2001;98(2):258-64. [PubMed]
- Gao X, Yeh YC, Outley J, Simon J, Botteman M, Spalding J. Health-related quality of life burden of women with endometriosis: a literature review. Curr Med Res Opin. 2006;22(9):1787-97. Review. [PubMed]
- Jones G, Jenkinson C, Kennedy S. Development of the Short Form Endometriosis Health Profile Ques-tionnaire: the EHP-5. Qual Life Res. 2004;13(3):695-704.
- Ballweg ML. Impact of endometriosis on women`s health: comparative historical data show that the earlier the onset, the more severe the disease. Best Pract Res Clin Obstet Gynaecol. 2004;18(2):201-18. [PubMed]
- Denny E. Women`s experience of endometriosis. J Adv Nurs. 2004;46(6):641-8. [PubMed]
- Ferrero S, Abbamonte LH, Parisi M, Ragni N, Remor-gida V. Dyspareunia and quality of sex life after laparoscopic excision of endometriosis and post-operative administration of triptorelin. Fertil Steril. 2007;87(1):227-9. [PubMed]
- Ferrero S, Abbamonte LH, Giordano M, Ragni N, Remorgida V. Deep dyspareunia and sex life after laparoscopic excision of endometriosis. Hum Reprod. 2007;22(4):1142-8. [PubMed]
- Denny E, Mann CH. Endometriosis-associated dys-pareunia: the impact on women`s lives. J Fam Plann Reprod Health Care. 2007;33(3):189-93. [PubMed]
- Jones G, Jenkinson C, Kennedy S. The impact of endometriosis upon quality of life: a qualitative analy-sis. J Psychosom Obstet Gynaecol. 2004;25(2):123-33 [PubMed]
- Marques A, Bahamondes L, Aldrighi JM, Petta CA. Quality of life in Brazilian women with endometriosis assessed through a medical outcome questionnaire. J Reprod Med. 2004;49(2):115-20. [PubMed]