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

Abstract

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.

Dahuang—Taoren, a botanical drug combination, ameliorates adenomyosis via inhibiting Rho GTPases

“…AM, defined as the presence of endometrial stroma and glands in the myometrium, is a prevalent disease in women that manifests varying symptomatology and adverse health outcomes. Among these, pain plays a central role in patients with AM ( Leuenberger et al, 2022 ). The management of AM is challenging and limiting.…”

Determinants of Pain-Induced Disability in German Women with Endometriosis during the COVID-19 Pandemic

“…In contrast, by using the PDI, we compared the influence of pain on seven different facets of life [ 27 , 46 ]. A recent study published by Leuenberger and colleagues found that women with endometriosis were often severely impaired in multiple areas of daily life, with up to one third of them recognizing severe impairment in up to nine distinct areas of daily life [ 79 ]. Impaired role performance and social functioning has been described previously as well [ 80 , 81 ].…”

“…Impaired participation in social activities, such as gatherings with friends or acquaintances, and occupational activities influenced global pain-induced disability to a lower extent, signaling than these activities are not as important as the ability for women with endometriosis to participate in family and recreational activities. Nevertheless, impaired socialization is a well-recognized factor with a negative influence on the quality of life of these patients [ 79 , 80 , 81 ]. Due to chronic pain, women with endometriosis report impaired occupational functioning, as they often cannot reach full professional fulfillment [ 79 , 80 , 81 ].…”

“…Nevertheless, impaired socialization is a well-recognized factor with a negative influence on the quality of life of these patients [ 79 , 80 , 81 ]. Due to chronic pain, women with endometriosis report impaired occupational functioning, as they often cannot reach full professional fulfillment [ 79 , 80 , 81 ]. The ability to perform in the work setting is a major social concern.…”

Higher miscarriage rate in subfertile women with endometriosis receiving unbiopsied frozen-warmed single blastocyst transfers

“…It is categorized by three phenotypes: superficial peritoneal lesions, ovarian endometriomas and deep infiltrating endometriosis (Chapron et al, 2019). Disease prevalence (5%-10%) varies as much as its clinical symptoms, ranging from pelvic pain over infertility and fatigue to asymptomatic cases (Ramin-Wright et al, 2018;Taylor et al, 2021;Leuenberger et al, 2022). Among women with infertility the prevalence of endometriosis is estimated to account for 35%-50% (Giudice and Kao, 2004;Prescott et al, 2016;Sanchez et al, 2020).…”