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  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">JPHI</journal-id>
      <journal-title-group>
        <journal-title>Journal of Public Health International</journal-title>
      </journal-title-group>
      <issn pub-type="epub">2641-4538</issn>
      <publisher>
        <publisher-name>Open Access Pub</publisher-name>
        <publisher-loc>United States</publisher-loc>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="publisher-id">JPHI-24-4976</article-id>
      <article-id pub-id-type="doi">10.14302/issn.2641-4538.jphi-24-4976</article-id>
      <article-categories>
        <subj-group>
          <subject>editorial</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Endometriosis, Mental Health and Quality of Life</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <name>
            <surname>Paraskevi</surname>
            <given-names>Theofilou</given-names>
          </name>
          <xref ref-type="aff" rid="idm1849754388">1</xref>
          <xref ref-type="aff" rid="idm1849751436">*</xref>
        </contrib>
      </contrib-group>
      <aff id="idm1849754388">
        <label>1</label>
        <addr-line>General Hospital of Thoracic Diseases SOTIRIA, Athens, Greece</addr-line>
      </aff>
      <aff id="idm1849751436">
        <label>*</label>
        <addr-line>Corresponding author</addr-line>
      </aff>
      <author-notes>
        <corresp>Paraskevi Theofilou, General Hospital of Thoracic Diseases SOTIRIA, Athens, Greece, <email>pardrothe@gmail.com</email></corresp>
        <fn fn-type="conflict" id="idm1841937564">
          <p>The authors have declared that no competing interests exist.</p>
        </fn>
      </author-notes>
      <pub-date pub-type="epub" iso-8601-date="2024-02-14">
        <day>14</day>
        <month>02</month>
        <year>2024</year>
      </pub-date>
      <volume>7</volume>
      <issue>1</issue>
      <fpage>43</fpage>
      <lpage>44</lpage>
      <history>
        <date date-type="received">
          <day>9</day>
          <month>02</month>
          <year>2024</year>
        </date>
        <date date-type="accepted">
          <day>12</day>
          <month>02</month>
          <year>2024</year>
        </date>
        <date date-type="online">
          <day>14</day>
          <month>02</month>
          <year>2024</year>
        </date>
      </history>
      <permissions>
        <copyright-statement>©</copyright-statement>
        <copyright-year>2024</copyright-year>
        <copyright-holder>Paraskevi Theofilou</copyright-holder>
        <license xlink:href="http://creativecommons.org/licenses/by/4.0/" xlink:type="simple">
          <license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p>
        </license>
      </permissions>
      <self-uri xlink:href="http://openaccesspub.org/jphi/article/2075">This article is available from http://openaccesspub.org/jphi/article/2075</self-uri>
      <abstract>
        <p>This article explores links between endometriosis, mental health, and quality of life. It reviews symptom burden, comorbidity patterns, and multidisciplinary care approaches.</p>
      </abstract>
      <kwd-group>
        <kwd>chronic pelvic pain</kwd>
        <kwd>infertility</kwd>
        <kwd>psychiatric symptoms</kwd>
        <kwd>depression</kwd>
        <kwd>anxiety disorders</kwd>
        <kwd>mental stress</kwd>
      </kwd-group>
      <counts>
        <fig-count count="0"/>
        <table-count count="0"/>
        <page-count count="2"/>
      </counts>
    </article-meta>
  </front>
  <body>
    <sec id="idm1849614324" sec-type="intro">
      <title>Introduction</title>
      <p>Endometriosis is associated with a multitude of symptoms such as chronic pelvic pain, painful intercourse and infertility. Their impact on the psychology and social life of women suffering from the disease is often significant <xref ref-type="bibr" rid="ridm1842641804">1</xref><xref ref-type="bibr" rid="ridm1842644324">2</xref>. This makes sense if one considers the negative impact of chronic pain on the social and professional life of patients. </p>
      <p>Pope et al. demonstrated that endometriosis is associated with a multitude of 
psychiatric symptoms, mainly depression, anxiety disorders and mental stress <xref ref-type="bibr" rid="ridm1842652972">3</xref>. However, the proportion of patients with psychiatric symptoms varies from study to study. In the study by Sepulcri and Do Amaral <xref ref-type="bibr" rid="ridm1842712436">4</xref>, almost 9 out of 10 women with endometriosis developed depression or anxiety disorders, in contrast to that of Friedl et al. <xref ref-type="bibr" rid="ridm1842495692">5</xref>, where less than 1/3 of patients developed these symptoms. The stage of the disease does not seem to be related to the likelihood of psychiatric symptoms; however, the patient's age is positively related to the likelihood of depression <xref ref-type="bibr" rid="ridm1842712436">4</xref>. Also, the presence of depression, per se, appears to be associated with worsening chronic pain reported by women with endometriosis. Since our understanding of the etiology of chronic pain remains incomplete, the coexistence of chronic pain and depression can create problems in distinguishing between cause and effect. </p>
      <p>As we mentioned, endometriosis is a major cause of infertility and infertility can have a negative effect on mental health. In a study by Berqvist and Theorell <xref ref-type="bibr" rid="ridm1842493460">6</xref>, which compared the mental health of women with infertility and endometriosis with that of women with endometriosis without infertility, 50% of the first group sought (or expressed a desire for) psychological help. </p>
      <p>Successful treatment of endometriosis (pharmacological or surgical) can reverse the negative impact of the disease on the mental health and overall quality of life of patients <xref ref-type="bibr" rid="ridm1842644324">2</xref>. However, long-term medication seems to have a negative effect, overall, on the quality of life of these women <xref ref-type="bibr" rid="ridm1842712436">4</xref>. Of particular interest is the study by Garry et al. <xref ref-type="bibr" rid="ridm1842480196">7</xref>, regarding the role of radical surgical removal of endometriosis foci: the authors demonstrated that this is associated with a significant improvement in patients' quality of life. </p>
      <p>Based on the above, it is recommended to assess the emotional profile and the overall quality of life as part of the holistic treatment of patients with endometriosis, both before the onset and during the treatment of the disease, as another indicator of its effectiveness. The successful treatment of endometriosis and its symptoms by health professionals with corresponding specialization is related to an improvement in the quality of life and mental health of patients with the disease.</p>
    </sec>
  </body>
  <back>
    <ref-list>
      <ref id="ridm1842641804">
        <label>1.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Friedl</surname>
            <given-names>F</given-names>
          </name>
          <name>
            <surname>Riedl</surname>
            <given-names>D</given-names>
          </name>
          <name>
            <surname>Fessler</surname>
            <given-names>S</given-names>
          </name>
          <article-title>Impact of endometriosis on quality of life, anxiety, and depression: an Austrian perspective.Arch Gynecol Obstet.292(6):</article-title>
          <date>
            <year>2015</year>
          </date>
          <fpage>1393</fpage>
          <lpage>1399</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842644324">
        <label>2.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Jia</surname>
            <given-names>S Z</given-names>
          </name>
          <name>
            <surname>Leng</surname>
            <given-names>J H</given-names>
          </name>
          <name>
            <surname>Shi</surname>
            <given-names>J H</given-names>
          </name>
          <name>
            <surname>Sun</surname>
            <given-names>P R</given-names>
          </name>
          <name>
            <surname>Lang</surname>
            <given-names>J H</given-names>
          </name>
          <article-title>Health-related quality of life in women with endometriosis: a systematic review. J Ovarian Res</article-title>
          <date>
            <year>2012</year>
          </date>
          <fpage>5</fpage>
          <lpage>1</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842652972">
        <label>3.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Pope</surname>
            <given-names>C J</given-names>
          </name>
          <name>
            <surname>Sharma</surname>
            <given-names>V</given-names>
          </name>
          <name>
            <surname>Sharma</surname>
            <given-names>S</given-names>
          </name>
          <name>
            <surname>Mazmanian</surname>
            <given-names>D</given-names>
          </name>
          <article-title>A systematic review of the association between psychiatric disturbances and endometriosis. J Obstet Gynaecol Can</article-title>
          <date>
            <year>2015</year>
          </date>
          <volume>37</volume>
          <issue>11</issue>
          <fpage>1006</fpage>
          <lpage>1015</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842712436">
        <label>4.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Sepulcri</surname>
            <given-names>Rde P</given-names>
          </name>
          <name>
            <surname>do</surname>
            <given-names>Amaral VF</given-names>
          </name>
          <article-title>Depressive symptoms, anxiety, and quality of life in women with pelvic endometriosis. Eur J Obstet Gynecol Reprod Biol</article-title>
          <date>
            <year>2009</year>
          </date>
          <volume>142</volume>
          <issue>1</issue>
          <fpage>53</fpage>
          <lpage>56</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842495692">
        <label>5.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Friedl</surname>
            <given-names>F</given-names>
          </name>
          <name>
            <surname>Riedl</surname>
            <given-names>D</given-names>
          </name>
          <name>
            <surname>Fessler</surname>
            <given-names>S</given-names>
          </name>
          <article-title>Impact of endometriosis on quality of life, anxiety, and depression: an Austrian perspective. Arch Gynecol Obstet</article-title>
          <date>
            <year>2015</year>
          </date>
          <fpage>292</fpage>
          <lpage>6</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842493460">
        <label>6.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Bergqvist</surname>
            <given-names>A</given-names>
          </name>
          <name>
            <surname>Theorell</surname>
            <given-names>T</given-names>
          </name>
          <article-title>Changes in quality of life after hormonal treatment of endometriosis</article-title>
          <date>
            <year>2001</year>
          </date>
          <source>Acta Obstet Gynecol Scand</source>
          <volume>80</volume>
          <fpage>628</fpage>
          <lpage>37</lpage>
        </mixed-citation>
      </ref>
      <ref id="ridm1842480196">
        <label>7.</label>
        <mixed-citation xlink:type="simple" publication-type="journal">
          <name>
            <surname>Garry</surname>
            <given-names>R</given-names>
          </name>
          <name>
            <surname>Clayton</surname>
            <given-names>R</given-names>
          </name>
          <name>
            <surname>Hawe</surname>
            <given-names>J</given-names>
          </name>
          <article-title>The effect of endometriosis and its radical laparoscopic excision on quality-of-life indicators</article-title>
          <date>
            <year>2000</year>
          </date>
          <source>Br J Obstet Gynecol</source>
          <fpage>107</fpage>
          <lpage>44</lpage>
        </mixed-citation>
      </ref>
    </ref-list>
  </back>
</article>
