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      Impact of Endometriosis on Life-Course Potential: A Narrative Review

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          Abstract

          Endometriosis may exert a profound negative influence on the lives of individuals with the disorder, adversely affecting quality of life, participation in daily and social activities, physical and sexual functioning, relationships, educational and work productivity, mental health, and well-being. Over the course of a lifetime, these daily challenges may translate into limitations in achieving life goals such as pursuing or completing educational opportunities; making career choices or advancing in a chosen career; forming stable, fulfilling relationships; or starting a family, all of which ultimately alter one’s life trajectory. The potential for endometriosis to impact the life course is considerable, as symptom onset generally occurs at a time of life (menarche through menopause, adolescence through middle age) when multiple life-changing and trajectory-defining decisions are made. Using a life-course approach, we examine how the known effects of endometriosis on life-domain satisfaction may impact health and well-being across the life course of affected individuals. We provide a quasi-systematic, narrative review of the literature as well as expert opinion on recommendations for clinical management and future research directions.

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          Most cited references104

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

          To assess the impact of endometriosis on health-related quality of life (HRQoL) and work productivity. Multicenter cross-sectional study with prospective recruitment. Sixteen clinical centers in ten countries. 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. None. Diagnostic delay, HRQoL, and work productivity. 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. 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. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
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            Participation rates in epidemiologic studies.

            Participation rates for epidemiologic studies have been declining during the past 30 years with even steeper declines in recent years. This wholesale decrease in participation rate, or at the very least the increase in refusal, has, quite understandably, occasioned some concern among epidemiologists who have long considered a high study participation rate as one of the hallmarks of a "good" epidemiologic study. In this review we synthesize the issues that are central to epidemiologic thinking around declining study participation rates. We consider the reasons why study participation has been declining, summarize what we know about who does participate in epidemiologic studies, and discuss the implications of declining participation rates. We conclude with a discussion of methods that may help improve study participation rates.
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              Clinical diagnosis of endometriosis: a call to action

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                Author and article information

                Journal
                Int J Gen Med
                Int J Gen Med
                ijgm
                ijgm
                International Journal of General Medicine
                Dove
                1178-7074
                07 January 2021
                2021
                : 14
                : 9-25
                Affiliations
                [1 ]Department of Obstetrics, Gynecology, and Reproductive Biology, Michigan State University , Grand Rapids, MI, USA
                [2 ]Department of Obstetrics and Gynecology, NorthShore University Health System , Evanston, IL, USA
                [3 ]Department of Reproductive Medicine, Center for Endometriosis Research and Treatment, University of California San Diego , La Jolla, CA, USA
                [4 ]Department of Gynecology Obstetrics II and Reproductive Medicine, Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique – Hôpitaux de Paris, Hôpital Universitaire Paris Centre, Centre Hospitalier Universitaire Cochin , Paris, France
                [5 ]AbbVie, Inc ., North Chicago, IL, USA
                [6 ]Department of Obstetrics and Gynecology, Ponce Health Sciences University – Ponce Research Institute, School of Medicine , Ponce, Puerto Rico
                [7 ]Department of Gynaecology and Reproductive Sciences, MRC Centre for Reproductive Health, University of Edinburgh , Edinburgh, UK
                [8 ]Harvard Medical Faculty Physicians, Beth Israel Deaconess Medical Center , Boston, MA, USA
                [9 ]Department of Obstetrics, Gynecology, and Reproductive Biology, Boston Center for Endometriosis and Boston Children’s Hospital and Brigham and Women’s Hospital , Boston, MA, USA
                [10 ]Department of Obstetrics and Gynaecology, McMaster University , Hamilton, Ontario, Canada
                [11 ]Department of Obstetrics and Gynaecology, University of Ottawa, and Ottawa Hospital Research Institute , Ottawa, Ontario, Canada
                [12 ]Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine , New Haven, CT, USA
                [13 ]Department of Obstetrics and Gynecology, University of Michigan Health System , Ann Arbor, MI, USA
                Author notes
                Correspondence: Stacey A Missmer College of Human Medicine, Michigan State University , 15 Michigan Street Northeast, Grand Rapids, MI49503, USATel +1 616 234 2705 Email missmers@msu.edu
                Author information
                http://orcid.org/0000-0002-8046-9807
                http://orcid.org/0000-0003-2130-4508
                http://orcid.org/0000-0002-6295-987X
                http://orcid.org/0000-0003-3437-0723
                http://orcid.org/0000-0002-2042-3751
                http://orcid.org/0000-0003-1720-8310
                Article
                261139
                10.2147/IJGM.S261139
                7800443
                33442286
                2532df30-7c98-410e-82fe-9a54f477105b
                © 2021 Missmer et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 14 August 2020
                : 08 December 2020
                Page count
                Figures: 2, Tables: 4, References: 104, Pages: 17
                Categories
                Review

                Medicine
                endometriosis,health trajectory,life-course impairment
                Medicine
                endometriosis, health trajectory, life-course impairment

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