Associations between health-related quality of life, infertility-related psychological well-being, and relationship quality in individuals with endometriosis: A cross-sectional study.

BACKGROUND

Endometriosis is the most frequent gynecological diseases and accompanied by both physical and psychological symptoms. An increasing number of studies suggested acknowledging endometriosis as a systematic disease due to the multifactorial effects throughout the body. The chronic disease significantly impacts daily life, including romantic relationships. This study aimed to investigate the associations between health-related quality of life (HRQoL), infertility-related psychological well-being (IPW), constructive communication, and relationship quality in individuals with endometriosis.

METHODS

A total of 627 individuals with endometriosis participated in this online cross-sectional study. We measured HRQoL in all participants and IPW specifically in those who reported an unfulfilled wish for a child. Additionally, relationship quality and constructive communication were assessed. We used Pearson's product moment correlation to examine the association of HRQoL/IPW and relationship quality. Mediation analysis was used to assess the role of constructive communication in the association between HRQoL/IPW and relationship quality. In an explorative analysis, differences between subsamples with and without an unfulfilled wish for a child were analyzed.

RESULTS

Poorer HRQoL was associated with lower relationship quality overall (p = .002) and specifically with three subscales of relationship quality: worse sexuality (p = .016), increased mistrust towards the partner (p < .001), and restriction of freedom/independence (p = .003). There was no significant association between IPW and relationship quality. The mediation analysis including constructive communication as mediator showed a full mediation between HRQoL/IPW and relationship quality. The subsamples with and without an unfulfilled wish for a child differed in HRQoL but not in relationship quality or constructive communication.

CONCLUSION

The findings indicated an association between HRQoL in individuals with endometriosis and relationship quality. In addition, we observed a full mediation between HRQoL/IPW and relationship quality, when constructive communication was considered as a mediator. Therefore, constructive communication plays a key role in effectively managing the impact of the disease within a relationship. Individuals with endometriosis experiencing difficulties conceiving should have access to appropriate psychological counseling.