LAUSR

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 multicenter cross-sectional case-control study analyzed the association between endometriosis-related chronic pain and functions of daily life in 510 women with endometriosis, 265 (52%) of whom 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, localization 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, defecation, 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.