Mental health, menstrual, and other pain symptoms are more common in women with endometriosis, according to a recent study published in the American Journal of Obstetrics & Gynecology.
Takeaways
- The study reveals that endometriosis is reported in 11.4% of women in Australia by the age of 44, underlining the substantial prevalence of this condition.
- The mean delay of 7 to 11 years between symptom onset and diagnosis has significant consequences, leading to increased symptoms, hospitalizations, and health care resource utilization.
- Women with endometriosis experience a wide range of symptoms beyond gynecological issues, including mental health symptoms (depression, anxiety), urinary and bowel symptoms, and nonspecific symptoms such as fatigue, headaches, and allergies.
- The study identifies associations between endometriosis and factors like urban residence, sedentary lifestyle, and being underweight.
- The study emphasizes the need for more research to explore the biological pathways connecting endometriosis with its associated symptoms.
Endometriosis, characterized by endometrium-like tissue outside the uterus, is reported in 11.4% of women in Australia by the age of 44 years. Endometriosis increases the risk of hospitalization, as well as decreasing work productivity and quality of life.
The mean delay of time between symptom onset and diagnosis is 7 to 11 years, causing increased symptoms, hospitalizations, and health care resource utilization. Data has also indicated women with endometriosis are at increased risk of chronic pelvic pain, heavy menstrual bleeding, dyspareunia, dyschezia, dysmenorrhea, and fatigue.
Most data on endometriosis and common symptoms come from cross-sectional or descriptive studies. Investigators evaluated the association between endometriosis and common symptoms using data from the Australian Longitudinal Study on Women’s Health (ALSWH), a large, population-based prospective cohort study.
Over 40,000 women across 3 age cohorts were included in the ALSWH. Patients completed 8 consecutive surveys through postal or online questionnaires. Surveys were completed every 3 years between 1996 and 2018.
In the current analysis, patients born between 1973 and 1978 who completed symptoms checklist surveys from 2009 to 2018 were included. Self-reported surveys and administrative health records were assessed to determine endometriosis incidence.
Endometriosis was categorized as clinically suspected or surgically confirmed, with an endometriosis diagnosis recorded in Medicare Benefits Schedule (MBS) or hospital data used to define surgically confirmed endometriosis. Cases of endometriosis only confirmed by self-report or endometriosis medication prescriptions were defined as clinically suspected endometriosis.
Women’s symptoms were evaluated using data from self-reported surveys in 2009, 2012, 2015, and 2018. Women were asked if they had experienced symptoms within the previous 12 months. Response options included never, rarely, sometimes, and often.
Symptoms included allergies, headaches, severe tiredness, indigestion, difficulty breathing, stiff joints, back pain, foot problems, skin problems, premenstrual tension, palpitations, severe period pain, heavy menstrual bleeding, irregular periods, leaking urine, urine burns, vaginal irritation, hemorrhoids, constipation, and bowel problems.
Covariates included women’s age, marital status, residence, income, education, alcohol intake, smoking, physical activity, body mass index, contraceptive use, and parity.
