Objective
Despite the high prevalence of uterine fibroids, the psychosocial impact of fibroids
has not been evaluated across different quality of life indicators and compared with
other chronic conditions. Here, we rigorously analyzed available evidence pertaining
to the psychosocial burden of uterine fibroids in premenopausal women and compared
validated quality of life and symptom scores before and after treatment.
Data Sources
We searched PubMed, PsycINFO, ClinicalTrials.gov, Embase, and Cochrane Library for publications from January 1990 to January 2020.
Study Eligibility Criteria
We considered English-language publications that evaluated the association between
uterine fibroids diagnosed by imaging studies in premenopausal women and quality of
life by standardized and validated questionnaires at baseline and after treatment.
We used a detailed list of terms related to quality of life, questionnaires, and uterine
fibroids to conduct the search.
Methods
Three reviewers screened titles and abstracts and then obtained full-text articles
for further analysis. The reviewers assessed risk of bias using established Cochrane
and Newcastle-Ottawa Scale guidelines. The quality of life scores of premenopausal
women with fibroids were reviewed at baseline and compared with those of published
quality of life scores in other disease populations in addition to after fibroid treatment.
Results
A total of 57 studies were included in the review: 18 randomized controlled trials
and 39 observational studies. Of note, the 36-Item Short Form Survey and European
Quality of Life Five-Dimension Scale questionnaires both indicated a diagnosis of
uterine fibroids to have a disability score that was similar to or exceeded (was a
greater psychosocial stressor) a diagnosis of heart disease, diabetes mellitus, or
breast cancer. Quality of life scores were lower at baseline than after treatment
in all instruments measuring these variables in women with uterine fibroids, indicating
significantly impaired psychosocial functioning. Uterine fibroids were associated
with significant patient-reported health disabilities related to bodily pain, mental
health, social functioning, and satisfaction with sex life.
Conclusion
A diagnosis of uterine fibroids was a significant psychosocial stressor among women
at baseline and relative to other diseases. Validated quality of life instruments
indicated therapeutic success and the improvement of both physical and emotional symptoms
after treatment.
Key words
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Article Info
Publication History
Published online: May 28, 2020
Accepted:
May 20,
2020
Received in revised form:
April 15,
2020
Received:
February 25,
2020
Footnotes
This research was supported, in part, by the Howard and Georgeanna Jones Endowment.
J.H.S. reports research funding for clinical trials from BioSpecifics Technologies Corporation, Bayer, Allergan, AbbVie Inc, and ObsEva. J.H.S. is a consultant to Bayer and Myovant Sciences. J.H.S. serves on the following boards: American Society for Reproductive Medicine, American Board of Obstetrics and Gynecology, Society for Reproductive Investigation, and American Gynecological and Obstetrical Society. The other authors report no conflict of interest.
Identification
Copyright
© 2020 Published by Elsevier Inc.
