Impact of Endometriosis on Life-Course Potential: A Narrative Review

Authors: Missmer SA, Tu FF, Agarwal SK, Chapron C, Soliman AM, Chiuve S, Eichner S, Flores-Caldera I, Horne AW, Kimball AB, Laufer MR, Leyland N, Singh SS, Taylor HS, As-Sanie S.

Publication: International Journal of General Medicine (2021) 14:9-25.

Synopsis:

Scientists often write about various factors that may contribute to the development of health conditions like endometriosis. However, this study did the opposite: it looked at the effects endometriosis has on people’s wellbeing. The authors analyzed information from 51 medical publications about endometriosis to better understand its potential impact on one’s life trajectory.

Key findings:

Debilitating menstrual pain (period pain), chronic pelvic pain (pain in the pelvis lasting more than 6 months), associated comorbidities (health conditions often seen alongside endometriosis), and infertility are factors that contribute to diminishing physical and mental health in people with endometriosis. 20 studies found pain and depression to be the reasons for significant school absences, loss of productivity, inability to pursue further education, and missed career opportunities. 11 studies found a link between endometriosis symptoms and limited ability to participate in social activities. 13 studies reported on intimate relationships challenges and sexual distress affecting as many as 78% of people with endometriosis. Pain and its unpredictable onset were found to critically affect mental health in participants across 16 studies, while infertility, fear of infertility, and inability to balance family planning and pain management were significant life burdens of people enrolled in 7 studies. The overall lower quality of life was associated with greater pain severity, psychological impacts of endometriosis, and younger age across 10 studies.

Conclusion:

While some studies used in Dr. Missmer’s review were limited by their small size, short-term duration, lack of controlled design and inclusivity, they still demonstrated the significant impact of endometriosis on wellbeing. Future long-term studies evaluating the chronic effects of endometriosis are needed as they will uncover the even broader impacts of the disease.

Take home message:

This study helps validate that endometriosis significantly shapes people’s lives. Importantly, the authors note that a lack of a timely diagnosis worsens the consequences of endometriosis symptoms. It can take up to 10 years to diagnose endometriosis; our team at AIMA and other researchers are working to expedite the diagnosis of chronic pelvic and period pain, so you can get the care you need sooner. In the short term, it is important to consider a full body and mind approach to prioritize overall wellbeing today. In our recent blog we highlighted the importance of psychological interventions for improving quality of life of people with endometriosis [Instagram post]. In addition to the validation received by a diagnosis, these strategies may help alleviate the impacts of endometriosis on quality of life.