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

Figures & data

Table 1 Summary of Endometriosis Publications

Publications	N = 51
Type of data
Cross-sectional study^a	37
Questionnaire-/interview-based study	19
Questionnaire	15
Interview	4
Questionnaire and interview	1
Conventional	12
Web-based survey	5
Case-control study	10
Cohort study	4
Prospective	2
Retrospective	2
Study Region^b
Europe	30
North America	13
Asia-Pacific	5
South America	4
Africa	3
Type of Journal
General	4
Specialist	47
Reproductive health	20
OB/GYN	18
Women’s health	4
Pain management	1
Managed care	1
Pediatrics	1
Sociology	1
Psychology	1

Notes: ^aCross-sectional studies were divided into questionnaire-/interview-based studies, conventional studies that did not use a questionnaire/interview or used one ad hoc, and web-based surveys. ^bStudies including countries from more than one region are included in each region represented; sum is larger than the total number of studies.

Figure 1 Connections between endometriosis-associated impairments and life impacts.

Figure 2 Theoretical effects of endometriosis on life-course trajectory. Life exposures and their influences on a patient’s attainments in life, education, family, career, etc. A comparison of untreated or persistently symptomatic endometriosis vs no endometriosis.

Table 2 Potential Factors Mediating the Impact of Endometriosis on Life Course at the Individual Level

Age at symptom onset and eventual diagnosis

Delay in diagnosis

Social/family/spouse support

Psychological considerations (eg, abuse/early traumatic exposures, stress, anxiety, depression)

Severity, frequency, and predictability^a of pain

Opioid use

Infertility

Pregnancy/successful livebirth

Comorbidities and their symptoms

Response (or non-response) to treatment

Number of surgeries

Geographic location

Financial status

Access to healthcare

Hysterectomy

Menopause

Patient resilience

Complementary and alternative medicine coping mechanisms, including mindfulness training or other mind-body interventions

Predisposition to pain/chronic pain syndromes

Note: ^aMany women report that although dysmenorrhea is their worst pain, non-menstrual pelvic pain is more problematic because of its lack of predictability, which leads to hesitancy in planning and engaging in activities (SKA, clinical observations).