Prevalence of Abuse in Women with Endometriosis and Relationship to Pain Symptoms: A Cross-Sectional Questionnaire Study

Abstract

Abstract Background Sexual and physical abuse are associated with endometriosis, but their relationship to pain in endometriosis patients has not been studied. The aim of this study was to characterize the prevalence of sexual and physical abuse history in an endometriosis population and its relationship to severity and type of pain symptoms. Methods This was a cross-sectional questionnaire study conducted from May 2017 to May 2018 at a tertiary care gynecology clinic. Women with clinically suspected or surgically confirmed endometriosis were included. Patients completed the Endometriosis Phenome and Biobanking Harmonization Project (EPHect) Clinical Questionnaire, the International Pelvic Pain Society Pelvic Pain Assessment Form, and the Medical Outcome Survey (SF-36). Relationships between history of sexual abuse or physical abuse, pelvic pain type and severity, anxiety/depression diagnosis, quality of life, and demographics were analysed using Chi square, independent t-tests, Mann-Whitney U test, and logistic regression models. Results Forty-four women were surveyed. Severity and type of pain symptoms were similar in patients with and without a history of sexual or physical abuse. Forty-three percent (n = 19) of patients with endometriosis reported history of physical abuse and 43% (n = 19) reported history of sexual abuse with a 68% overlap between both groups. Patients with a history of sexual abuse had significantly higher rates of depression (53% vs 16%; p = 0.012) and anxiety (58% vs 12%; p = 0.001) than those reporting no history of sexual abuse and reported significantly lower mean SF-36 mental component summary scores (34 ± 14 vs 42 ± 12, p = 0.028). Conclusions No differences in severity and type of pain symptoms in patients with a history of sexual or physical abuse were observed compared to those without. More than 40% (n = 19) of patients with endometriosis reported a history of sexual abuse, with more anxiety and depression and lower mental quality of life scores compared to patients who reported no history of sexual abuse. This highlights the need for sexual abuse and mental health screening in an endometriosis population.