Endometriosis and perceived stress: impact of surgical and medical treatment.

BACKGROUND: The aim of the study was to investigate the levels of perceived stress in a group of women with a long-term history of endometriosis in conjunction with surgical and/or medical treatments. METHODS: A clinical trial was conducted at the Department of Molecular and Developmental Medicine, University of Siena, in collaboration with a non-profit association of women with endometriosis, A.P.E. Onlus. Patients (n = 204) with a previous diagnosis of endometriosis (for at least 3 years) were included in this study. Each patient completed a semi-structured questionnaire and a validated scale to assess perceived stress, the Perceived Stress Scale (PSS) by e-mail. RESULTS: The study showed that in women with a long-term history of endometriosis, the level of perceived stress was increased by repeated surgical treatments and reduced by some medical treatments. The median PSS value was 23 (range 9-36) and 30.6% of the study population were included in the highest stress category (>26). The highest levels were found in patients who had undergone the most surgery. The use of progestins was associated with a lower perceived stress (p = 0.004) than in the patients treated with gonadotropin-releasing hormones. CONCLUSIONS: Long-term endometriosis has a relevant impact on perceived stress, in particular in those undergoing repeated surgery.

Mood disorders and sexual functioning in women with functional hypothalamic amenorrhea.

OBJECTIVE: To investigate the sexual function of women with functional hypothalamic amenorrhea (FHA) and to test the mediating effects of depression and anxiety on the sexual functioning of women with FHA. DESIGN: In this cross-sectional study, participants completed questionnaires on sexual function, depression, and anxiety. SETTING: Tertiary care university hospital. PATIENT(S): Women with (n=41) and without (n=39) FHA recruited from a gynecologic endocrinology unit. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): The McCoy Female Sexuality Questionnaire assessed sexual function, and the Zung Scale measured depression and anxiety. RESULT(S): Women with FHA experienced more sexual function problems and significantly higher depression and anxiety compared to women without menstrual dysfunction. In addition, depression offered a significant explanation for the sexual problems experienced by women with FHA. CONCLUSION(S): The psychologic symptoms that contribute to the onset of FHA partially mediate the relationship between FHA and sexual dysfunction.