Patient characteristics and lifestyle determinants of quality of life among women with endometriosis: a systematic review

Clinical Snapshot

Key Findings

• P Value: Not applicable - systematic review

• Effect Size: Not quantified - narrative synthesis

• Primary Outcome: Quality of life in women with endometriosis

• Nnt Or Sensitivity: Not applicable - multiple factors identified rather than single intervention

• Confidence Interval: Not reported

Clinical Application

Highly feasible - focuses on modifiable lifestyle and psychosocial factors Relevant to Australian practice; supports RACGP guidelines on holistic endometriosis care and aligns with PBS-funded psychological interventions for chronic pain Women with endometriosis in primary care, gynaecology, and pain management settings

Abstract

ABSTRACT: Endometriosis is a chronic inflammatory disease presenting with debilitating symptoms strongly impacting patients' quality of life (QoL). Assessing QoL is crucial for understanding the full patient experience beyond clinical symptoms. This narrative systematic review specifically aimed to identify and describe non-pharmacological and non-surgical factors associated with QoL in women with endometriosis as reported in the literature. Following PRISMA guidelines, we systematically searched PubMed, MEDLINE, Web of Science, and Embase up to January 15, 2025, for case-control, cohort, randomized controlled trials, and cross-sectional studies. This study was registered in PROSPERO (registration number: CRD42023438457) Eligible studies assessed socio-demographic characteristics, lifestyle factors, symptoms, comorbidities, or coping strategies in relation to QoL among women with endometriosis. Twenty-one studies with a low risk of bias were included. A better QoL was related to favorable socioeconomic profiles (n = 3), high care satisfaction (n = 2), partner involvement (n = 1), healthier lifestyle habits (n = 1), and the use of coping therapeutic strategies. Poor QoL was associated with poor health (n = 5), more severe symptoms (n = 5), unhealthy lifestyle habits (n = 2), and ineffective use of coping strategies (n = 2). This review highlights a broad range of non-medical determinants of QoL, underscoring that clinical measures alone fail to capture the full patient experience. By consolidating evidence across diverse study designs, it offers a comprehensive overview of modifiable factors that could inform holistic, patient-centered approaches to endometriosis care. Further prospective and interventional studies are needed to clarify causal pathways and evaluate the effectiveness of targeted strategies to improve QoL. LAY SUMMARY: Endometriosis is a chronic disease affecting around 10% of women of reproductive age, associated with pain, infertility, and significant impacts on daily life. Because clinical measures alone fail to capture the full patient experience, assessing QoL is essential to understand the real burden of the disease. This review examined non-pharmacological and non-surgical factors that may be associated with QoL, such as lifestyle habits, socioeconomic conditions, health status, and coping strategies. Across 21 studies, we found that a better QoL was linked to good healthcare access, healthy habits, and effective coping mechanisms. Conversely, severe symptoms, poor health, and unhealthy lifestyles (smoking and alcohol use) were associated with worse QoL. The findings highlight the need for a more holistic approach to endometriosis care, combining psychological support, lifestyle guidance, and improved access to quality healthcare. Future research should use standardized QoL tools and robust study designs to develop evidence-based strategies that can meaningfully enhance patient well-being.

References

1. 1.Breton, Z., Colombo, G. E., Mokraoui, N., Mahamat-Saleh, Y., Pinault, M., Conforti, J., Naudin, S., Alexaline, M., & Kvaskoff, M. (2026). Patient characteristics and lifestyle determinants of quality of life among women with endometriosis: a systematic review. Reproduction & Fertility. https://doi.org/10.1530/RAF-25-0094