Comorbidities and Quality of Life in Women Undergoing First Surgery for Endometriosis: Differences Between Chinese and Italian Population

Chen, Huixi; Vannuccini, Silvia; Capezzuoli, Tommaso; Ceccaroni, Marcello; Liu, Mubiao; Huang, Shuting; Wu, Yanting; Huang, He‐Feng

doi:10.1007/s43032-021-00487-5

Cited by 12 publications

(11 citation statements)

References 46 publications

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“…A recent study has demonstrated that QoL of women with endometriosis may be related also to the ethnicity, the different health system organization and the social and cultural background. Italian women seemed to be more commonly affected by systemic comorbidities, especially inflammatory diseases and mental health disorders (such as depression and anxiety) compared to Chinese population [47].…”

Section: Discussionmentioning

confidence: 92%

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Gynaecologic and Systemic Comorbidities in Patients with Endometriosis: Impact on Quality of Life and Global Health

Capezzuoli¹,

Orlandi²,

Clemenza³

et al. 2022

Clin. Exp. Obstet. Gynecol.

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Objectives:Endometriosis is an inflammatory disease characterized by a frequent association with gynecologic and systemic comorbidities. Our aim was to evaluate which gynecologic and systemic comorbidities occur in women affected by endometriosis and their impact on quality of life and global health. Mechanism: A literature search of the PubMed, Cochrane Library, Scopus and Web of Science databases was performed to identify the relevant studies published before December 31, 2021. We selected clinical studies, systematic reviews, and meta-analyses in English. Findings in Brief: Endometriosis is strongly associated with gynecologic (adenomyosis, uterine fibroids, polycystic ovarian syndrome-PCOS) and systemic (autoimmune, inflammatory, psychiatric and neurological disorders) comorbidities that impair women quality of life and global health through multiple mechanisms, influencing everyday life and work activities. Conclusions: Endometriosis is a chronic disease, impairing multiple functioning areas and affecting women's health and everyday life. Considering the co-existence of multiple both gynecological and non-gynecological disorders, endometrisois needs a multidisciplinary approach. Thus, specialized referral centres are warranted for a personalized management, focused on patient symptoms and comorbidities.

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Section: Discussionmentioning

confidence: 92%

“…1) [29,31]. This is particularly important in presence of DIE phenotype because it is more frequently linked to a more severe and aggressive clinical presentation, with an increased rate of intractable chronic pelvic pain, severe dyspareunia, bowel occlusion and hydroureteronephrosis [47].…”

Section: Discussionmentioning

confidence: 99%

Gynaecologic and Systemic Comorbidities in Patients with Endometriosis: Impact on Quality of Life and Global Health

Capezzuoli¹,

Orlandi²,

Clemenza³

et al. 2022

Clin. Exp. Obstet. Gynecol.

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“…Evaluation of QoL was not a scope of our study, but it is interesting that the individual perception of psychophysical well-being improved in all women who breastfed, and particularly in those who exclusively breastfed. This effect may be related not only to pain improvement, but also to the emotional impact associated with breastfeeding [50].…”

Section: Discussionmentioning

confidence: 99%

Effects of Breastfeeding on Endometriosis-Related Pain: A Prospective Observational Study

Porta¹,

Sangiuliano

Cavalli

et al. 2021

IJERPH

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Endometriosis is a gynecological estrogen-dependent disease whose commonest pain symptoms are dysmenorrhea, dyspareunia, and acyclic chronic pelvic pain (CPP). Hormonal changes occurring during breastfeeding seem to reduce pain and disease recurrence. The aim of this observational prospective study was to assess the effect of breastfeeding on pain and endometriotic lesions in patients with endometriosis and to evaluate a possible correlation between the duration of breastfeeding, postpartum amenorrhea, and pain. Out of 156 pregnant women with endometriosis enrolled, 123 who breastfed were included in the study and were monitored for 2 years after delivery; 96/123 exclusively breastfed for at least 1 month. Mode of delivery, type and duration of breastfeeding, intensity of pain symptoms, and lesion size before pregnancy and during the 24-month follow-up were analyzed. All patients experienced a significant reduction in dysmenorrhea proportional to the duration of breastfeeding. CPP was significantly reduced only in women who exclusively breastfed. No significant improvement in dyspareunia was observed. Ovarian endometriomas were significantly reduced. Therefore, breastfeeding, particularly if exclusive, may cause improvement in dysmenorrhea and CPP proportional to the duration of breastfeeding, as well as a reduction in the size of ovarian endometriomas.

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“…The analysis of the impact of specific endometriotic lesions was hampered by two things: first, the surgical reports and the recording of lesion characteristics were not uniform, due to different expertise in different hospitals; second, finding a clear association between specific endometriotic lesions and associated pain was complicated by women having multiple lesions rather than isolated endometriotic lesions. Because socio-cultural factors have been shown to influence pain perception (Chen et al, 2021;Facchin et al, 2015), our predominantly Caucasian study group limits generalisability.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Living with endometriosis: Comorbid pain disorders, characteristics of pain and relevance for daily life

Leuenberger

Schwartz

Geraedts

et al. 2022

European Journal of Pain

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Background Pain plays a central role in endometriosis. The complex relationship among pain characteristics, comorbid pain disorders and daily life represents a challenge for medical support. This multicentre cross‐sectional case–control study analysed the association between endometriosis‐related chronic pain and functions of daily life in 510 women with endometriosis, 265 (52%) who experienced chronic pain, either from endometriosis alone (N = 134, 26.3%) or in association with additional pain disorders (N = 131, 25.7%). Methods Self‐administered questionnaires from the Brief Pain Inventory and the Pain Disability Index were used to investigate associations between pain characteristics (frequency, duration, intensity) and daily life. Also, associations between different endometriosis characteristics (rASRM stage, presence of adhesions, localisation of lesions) and pain were evaluated. Results Chronic pain is negatively associated with almost all (12/14) aspects of daily life investigated, including standing, walking, sitting, defaecation, sleep, sports activities, family and domestic responsibilities, sexuality, social functioning, professional life, mood, and joy of life. Altogether, 33.7% of women with chronic pain reported moderate and 27.5% severe limitations. Comorbid pain disorders resulted in significantly more limitations. The length of pain episodes showed a particularly important influence, especially for family/domestic responsibilities (OR 22.94, p < 0.001), professional life (OR 16.56, p < 0.001) and social functioning (OR 41.03, p < 0.001). Conclusions Our data confirm that despite treatment, about 50% of women experience pain. Pain was associated with at least moderate negative effects on almost all areas of daily life; additional pain comorbidities increased limitations. Improving pain management is essential for improving quality of life in women with endometriosis. Significance The study provides an accurate overview of the impact of endometriosis‐associated pain on daily life. This is important because pain plays a central role in women living with endometriosis, and despite modern therapies, many women continue to suffer from chronic pain. The detailed analysis of its impact with a comprehensive survey of all aspects of daily life in a very large study population is unique. We expect an improved understanding of consequences of pain to significantly advance medical support in these patients.

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Comorbidities and Quality of Life in Women Undergoing First Surgery for Endometriosis: Differences Between Chinese and Italian Population

Cited by 12 publications

References 46 publications

Gynaecologic and Systemic Comorbidities in Patients with Endometriosis: Impact on Quality of Life and Global Health

Gynaecologic and Systemic Comorbidities in Patients with Endometriosis: Impact on Quality of Life and Global Health

Effects of Breastfeeding on Endometriosis-Related Pain: A Prospective Observational Study

Living with endometriosis: Comorbid pain disorders, characteristics of pain and relevance for daily life

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