Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries.

By K. Nnoaham, L. Hummelshoj, P. Webster, T. D’Hooghe, F. De Cicco Nardone, C. De Cicco Nardone, C. Jenkinson, S. Kennedy, Krina T. Zondervan. Fertility and Sterility, 2011

1,395 citations recorded by the source corpus.

OBJECTIVE To assess the impact of endometriosis on health-related quality of life (HRQoL) and work productivity. DESIGN Multicenter cross-sectional study with prospective recruitment. SETTING Sixteen clinical centers in ten countries. PATIENT(S) A total of 1,418 premenopausal women, aged 18-45 years, without a previous surgical diagnosis of endometriosis, having laparoscopy to investigate symptoms or to be sterilized. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Diagnostic delay, HRQoL, and work productivity. RESULT(S) There was a delay of 6.7 years, principally in primary care, between onset of symptoms and a surgical diagnosis of endometriosis, which was longer in centers where women received predominantly state-funded health care (8.3 vs. 5.5 years). Delay was positively associated with the number of pelvic symptoms (chronic pelvic pain, dysmenorrhoea, dyspareunia, and heavy periods) and a higher body mass index. Physical HRQoL was significantly reduced in affected women compared with those with similar symptoms and no endometriosis. Each affected woman lost on average 10.8 hours (SD 12.2) of work weekly, mainly owing to reduced effectiveness while working. Loss of work productivity translated into significant costs per woman/week, from US$4 in Nigeria to US$456 in Italy. CONCLUSION(S) Endometriosis impairs HRQoL and work productivity across countries and ethnicities, yet women continue to experience diagnostic delays in primary care. A higher index of suspicion is needed to expedite specialist assessment of symptomatic women. Future research should seek to clarify pain mechanisms in relation to endometriosis severity.

Subfields: Endocrinology, Diabetes and Metabolism, Public Health, Environmental and Occupational Health, Reproductive Medicine

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1. L. Culley
2. C. Law
3. A. Horne
4. G. Dunselman
5. S. Simoens
6. L. Hummelshoj
7. N. Hudson
8. E. Denny

Citations in the corpus

• The burden of endometriosis: costs and quality of life of women with endometriosis and treated in referral centres. (2012, background): “, 2006a,b) and with recently published papers (Fourquet et al., 2011; Nnoaham et al., 2011), concluding that endometriosis impairs health-related quality of life especially in the domains of pain, psychological and social functioning.”
• ESHRE guideline: management of women with endometriosis. (2014, background): “Recent studies report, specifically for Europe, an overall diagnostic delay of 10 years in Germany and Austria, 8 years in the UK and Spain, 7 years in Norway, 7–10 years in Italy and 4–5 years in Ireland and Belgium (Ballard et al., 2006; Nnoaham et al., 2011; Hudelist et al., 2012).”
• The social and psychological impact of endometriosis on women's lives: a critical narrative review. (2013, background): “Similarly, Nnoaham et al. (2011) found that women with endometriosis lost an average of 10.8 h weekly, but this was mainly due to reduced effectiveness at work, as opposed to absenteeism.”
• Pathogenesis and Pathophysiology of Endometriosis (2012, neutral): “7-year mean latency from onset of symptoms to definitive diagnosis (3), in part owing to the requirement for surgical diagnosis.”