Quality of life in women with endometriosis in Portugal: a cross-sectional study on the roles of social support and sexual satisfaction

Autor

Słowa kluczowe:

perceived social support, sexual satisfaction, quality of life, endometriosis

Abstrakt

Background:

Endometriosis, a chronic and often painful gynecological condition characterized by the presence of endometrial-like tissue outside the uterine cavity, significantly impacts multiple facets of women’s lives, including their sexual health, psychologi-cal well-being, and overall quality of life. The heterogeneous presentation of symptoms, ranging from dysmenorrhea and dyspareunia to infertility, exerts not only a physical toll but also an emotional and social burden. This cross-sectional study explored how social support contributed to the quality of life in Portuguese-speaking women residing in Portugal with en-dometriosis and how sexual satisfaction could contribute to explaining these associations.

Participants and procedure:

A total of 106 women with a self-reported diagnosis of endometriosis, with a mean age of 33.54 years (SD = 7.43), partici-pated in the study. Data were collected online between January and May 2024 using self-report measures of quality of life, sexual satisfaction, and perceived social support.

Results:

The results revealed that higher social support is significantly associated with greater sexual satisfaction (B = .17, SE = .06, t = 2.84, p < .001, 95% CI [.05, .29]) and improved overall quality of life (B = .19, SE = .03, t = 5.44, p < .001, 95% CI [.12, .26]). Sexual satisfaction significantly mediated the relationship between social support and quality of life (indirect ef-fect = .05, SE = .02, 95% CI [.01, .09].

Conclusions:

These findings underscore the importance of social connections and sexual health in managing endometriosis among Portu-guese-speaking women residing in Portugal, offering valuable insights for clinical practice and future research on holistic care for women with chronic conditions.

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Bibliografia

Adamson, G. D., Kennedy, S., & Hummelshoj, L. (2010). Creating solutions in endometriosis: Global collaboration through the World Endometriosis Research Foundation. Journal of Endometriosis, 2, 3–6. https://doi.org/10.1177/228402651000200102

Ameratunga, D., Flemming, T., Angstetra, D., Ng, S. K., & Sneddon, A. (2017). Exploring the impact of endometriosis on partners. Journal of Obstetrics and Gynaecology Research, 43, 1048–1053. https://doi.org/10.1111/jog.13325

As-Sanie, S., Mackenzie, S. C., Morrison, L., Schrepf, A., Zondervan, K. T., Horne, A. W., & Missmer, S. A. (2025). Endometriosis: a review. JAMA, 334, 64–78. https://doi.org/10.1001/jama.2025.2975

Bień, A., Rzońca, E., Zarajczyk, M., Wilkosz, K., Wdowiak, A., & Iwanowicz-Palus, G. (2020). Quality of life in women with endometriosis: a cross-sectional survey. Quality of Life Research, 29, 2669–2677. https://doi.org/10.1007/s11136-020-02515-4

Carvalho, S., Pinto-Gouveia, J., Pimentel, P., Mala, D., & Mota-Pereira, J. (2011). Características psicométricas da versão portuguesa da Escala Multidimensional de Suporte Social Percebido (Multidimensional Scale of Perceived Social Support – MSPSS) [Psychometric properties of Portuguese version

of the Multidimensional Scale of Perceived Social Support (MSPSS)]. Psychologica, 54, 309–358.

Culley, L., Law, C., Hudson, N., Mitchell, H., Denny, E., & Raine-Fenning, N. (2017). A qualitative study of the impact of endometriosis on male partners. Human Reproduction, 32, 1667–1673. https://doi.org/10.1093/humrep/dex221

De Corte, P., Klinghardt, M., von Stockum, S., & Heinemann, K. (2025). Time to diagnose endometriosis: Current status, challenges and regional characteristics – a systematic literature review. BJOG: An International Journal of Obstetrics & Gynaecology, 132, 118–130. https://doi.org/10.1111/1471-0528.17973

Della-Corte, L., Di Filippo, C., Gabrielli, O., Reppuccia, S., La Rosa, V. L., Ragusa, R., Fichera, M., Commodari, E., Bifulco, G., & Giampaolino, P. (2020). The burden of endometriosis on women’s lifespan: a narrative overview on quality of life and psychosocial wellbeing. International Journal of Environmental

Research and Public Health, 17, 4683. https://doi.org/10.3390/ijerph17134683

Duarte, A. N., & Righi, M. (2021). Associação entre endometriose e infertilidade feminina: Uma revisão de literature [The association between endometriosis and female infertility: a literature review]. Acta Elit Salutis, 4, 26895. https://doi.org/10.48075/aes.v4i1.26895

Facchin, F., Buggio, L., & Saita, E. (2020). Partners’ perspective in endometriosis research and treatment: a systematic review of qualitative and quantitative evidence. Journal of Psychosomatic Research, 137, 110213. https://doi.org/10.1016/j.jpsychores.2020.110213

Flynn, K. E., Lin, L., Bruner, D. W., Cyranowski, J. M., Hahn, E. A., Jeffery, D. D., Reese, J. B., Reeve, B. B., Shelby, R. A., & Weinfurt, K. P. (2016). Sexual satisfaction and the importance of sexual health to quality of life throughout the life course of U.S. adults. Journal of Sexual Medicine, 13, 1642–1650. https://doi.org/10.1016/j.jsxm.2016.08.011

Fourquet, J., Gao, X., Zavala, D., Orengo, J. C., Abac, S., Ruiz, A., Laboy, J., & Flores, I. (2010). Patients’ report on how endometriosis affects health, work, and daily life. Fertility and Sterility, 93, 2424–2428. https://doi.org/10.1016/j.fertnstert.2009.09.017

Fritzer, N., Haas, D., Oppelt, P., Renner, S., Hornung, D., Wölfler, M., Ulrich, U., Fischerlehner, G., Sillem, M., & Hudelist, G. (2013). More than just bad sex: Sexual dysfunction and distress in patients with endometriosis. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 169, 392–396. https://doi.org/10.1016/j.ejogrb.2013.04.001

Gao, X., Yeh, Y. C., Outley, J., Simon, J., Botteman, M., & Spalding, J. (2006). Health-related quality of life burden of women with endometriosis: a literature review. Current Medical Research and Opinion, 22, 1787–1797. https://doi.org/10.1185/030079906X121084

Gewirtz-Meydan, A., Hafford-Letchfield, T., Ayalon, L., Benyamini, Y., Biermann, V., & Coffey, A. (2019). How do older people discuss their own sexuality? A systematic review of qualitative research studies. Culture, Health & Sexuality, 21, 293–308. https://doi.org/10.1080/13691058.2018.1465203

Ghiasi, M., Kulkarni, M. T., & Missmer, S. A. (2020). Is endometriosis more common and more severe than it was 30 years ago? Journal of Minimally Invasive Gynecology, 27, 452–461. https://doi.org/10.1016/j.jmig.2019.11.018

Granero-Molina, J., Matarín Jiménez, T. M., Ramos Rodríguez, C., Hernández-Padilla, J. M., Castro-Sánchez, A. M., & Fernández-Sola, C. (2018). Social support for female sexual dysfunction in fibromyalgia. Clinical Nursing Research, 27, 296–314. https://doi.org/10.1177/1054773816676941

Gruber, T. M., & Mechsner, S. (2021). Pathogenesis of endometriosis: The origin of pain and subfertility. Cells, 10, 1381. https://doi.org/10.3390/cells10061381

Hayes, A. F. (2017). Introduction to mediation, moderation, and conditional process analysis: a regression-based approach (2nd ed.). Guilford Press.

Hsu, A. L., Khachikyan, I., & Stratton, P. (2010). Invasive and noninvasive methods for the diagnosis of endometriosis. Clinical Obstetrics and Gynecology, 53, 413–419. https://doi.org/10.1097/GRF.0b013e3181db7ce8

Hudson, N., Culley, L., Mitchell, H., Law, C., Denny, E., & Raine-Fenning, N. (2013). Endometriosis: Improving the wellbeing of couples. Summary report and recommendations. Retrieved from www.dmu.ac.uk/endopartreport

Kalfas, M., Chisari, C., & Windgassen, S. (2022). Psychosocial factors associated with pain and healthrelated quality of life in endometriosis: a systematic review. European Journal of Pain, 26, 1827–1848. https://doi.org/10.1002/ejp.2006

Kengen Traska, T., Rutledge, D. N., Mouttapa, M., Weiss, J., & Aquino, J. (2012). Strategies used for managing symptoms by women with fibromyalgia. Journal of Clinical Nursing, 21, 626–635. https://doi.org/10.1111/j.1365-2702.2010.03501.x

Kfoury, M., Barakat, H., Hallit, S., & Saliba, S. (2023). Association between endometriosis and sexual satisfaction among a sample of Lebanese women. BMC Women’s Health, 23, 164. https://doi.org/10.1186/s12905-023-02361-4

La Rosa, V. L., Barra, F., Chiofalo, B., Platania, A., Di Guardo, F., & Conway, F. (2020). An overview on the relationship between endometriosis and infertility: The impact on sexuality and psychological well-being. Journal of Psychosomatic Obstetrics & Gynecology, 41, 93–97. https://doi.org/10.1080/0167482X.2019.1659775

Laganà, A. S., La Rosa, V. L., Rapisarda, A. M. C., Valenti, G., Sapia, F., Chiofalo, B., Rossetti, D., Ban Frangež, H., Vrtačnik Bokal, E., & Vitale, S. G. (2017). Anxiety and depression in patients with endometriosis: Impact and management challenges. International Journal of Women’s Health, 9, 323–330. https://doi.org/10.2147/IJWH.S119729

Law, C., Hudson, N., Mitchell, H., Culley, L., & Norton, W. (2025). ‘You feel like you’re drifting apart’: a qualitative study of impacts of endometriosis on sex and intimacy amongst heterosexual couples. Sexual and Relationship Therapy, 40, 142–165. https://doi.org/10.1080/14681994.2024.2306316

Li, W., Feng, H., & Ye, Q. (2025). Relationship between endometriosis and mental health. A systematic review and meta-analysis. Archives of Medical Science, 21, 1985–1996. https://doi.org/10.5114/aoms/208502

Luo, Z., Zhong, S., Zheng, S., Li, Y., Guan, Y., Xu, W., Li, L., Liu, S., Zhou, H., Yin, X., Wu, Y., Liu, D., & Chen, J. (2023). Influence of social support on subjective well-being of patients with chronic diseases in China: Chain-mediating effect of selfefficacy and perceived stress. Frontiers in Public Health, 11, 1184711. https://doi.org/10.3389/fpubh.2023.1184711

Maguire, R., Hanly, P., & Maguire, P. (2021). Living well with chronic illness: How social support, loneliness and psychological appraisals relate to well-being in a population-based European sample. Journal of Health Psychology, 26, 1494–1507. https://doi.org/10.1177/1359105319883004

Marinho, M. C. P., Magalhaes, T. F., Fernandes, L. F. C., Augusto, K. L., Brilhante, A. V. M., & Bezerra, L. R. P. S. (2018). Quality of life in women with endometriosis: an integrative review. Journal of Women’s Health, 27, 399–408. https://doi.org/10.1089/jwh.2017.63

Márki, G., Vásárhelyi, D., Rigó, A., Kaló, Z., Ács, N., & Bokor, A. (2022). Challenges of and possible solutions for living with endometriosis: a qualitative study. BMC Women’s Health, 22, 20. https://doi.org/10.1186/s12905-022-01603-6

Missmer, S. A., Tu, F. F., Agarwal, S. K., Chapron, C., Soliman, A. M., Chiuve, S., Eichner, S., Flores-Caldera, I., Horne, A. W., Kimball, A. B., Laufer, M. R., Leyland, N., Singh, S. S., Taylor, H. S., & As-Sanie, S. (2021). Impact of endometriosis on life-course potential: a narrative review. International Journal of General Medicine, 14, 9–25. https://doi.org/10.2147/IJGM.S261139

Montanari, G., Di Donato, N., Benfenati, A., Giovanardi, G., Zannoni, L., Vicenzi, C., Solfrini, S., Mignemi, G., Villa, G., Mabrouk, M., Schioppa, C., Venturoli, S., & Seracchioli, R. (2013). Women with deep infiltrating endometriosis: Sexual satisfaction, desire, orgasm, and pelvic problem interference with sex. Journal of Sexual Medicine, 10, 1559–1566. https://doi.org/10.1111/jsm.12133

Moradi, M., Parker, M., Sneddon, A., Lopez, V., & Ellwood, D. (2014). Impact of endometriosis on women’s lives: a qualitative study. BMC Women’s Health, 14, 123. https://doi.org/10.1186/1472-6874-14-123

Nnoaham, K. E., Hummelshoj, L., Webster, P., d’Hooghe, T., de Cicco Nardone, F., de Cicco Nardone, C., Jenkinson, C., Kennedy, S. H., Zondervan, K. T., & World Endometriosis Research Foundation Global Study of Women’s Health consortium (2011). Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries. Fertility and Sterility, 96, 366–373. https://doi.org/10.1016/j.fertnstert.2011.05.090

Norinho, P., Martins, M. M., & Ferreira, H. (2020). A systematic review on the effects of endometriosis on sexuality and couple’s relationship. Facts, Views & Vision in ObGyn, 12, 197–205.

Pechorro, P. S., Pascoal, P. M., Jesus, S. N., Almeida, A. I., Figueiredo, C. S., & Vieira, R. X. (2016). Propriedades psicométricas da versão portuguesa da Nova Escala de Satisfação Sexual – versão curta [Psychometric properties of the Portuguese version of the New Sexual Satisfaction Scale–Short]. Revista Internacional de Andrología, 14, 94–100. https://doi.org/10.1016/j.androl.2016.04.006

Pérez-López, F. R., Ornat, L., Pérez-Roncero, G. R., López-Baena, M. T., Sánchez-Prieto, M., & Chedraui, P. (2020). The effect of endometriosis on sexual function as assessed with the Female Sexual Function Index: Systematic review and meta-analysis. Gynecological Endocrinology, 36, 1015–1023. https://doi.org/10.1080/09513590.2020.1812570

Røssell, E. L., Plana-Ripoll, O., Josiasen, M., Hansen, K. E., Bech, B. H., & Rytter, D. (2025). Association between endometriosis and working life among Danish women. Human Reproduction, 40, 461–468. https://doi.org/10.1093/humrep/deae298

Sánchez-Fuentes, M. M., Santos-Iglesias, P., & Sierra, J. C. (2014). A systematic review of sexual satisfaction. International Journal of Clinical and Health Psychology, 14, 67–75. https://doi.org/10.1016/S1697-2600(14)70038-9

Schick, M., Germeyer, A., Böttcher, B., Hecht, S., Geiser, M., Rösner, S., Eckstein, M., Vomstein, K., Toth, B., Strowitzki, T., Wischmann, T., & Ditzen, B. (2022). Partners matter: The psychosocial well-being of couples when dealing with endometriosis. Health and Quality of Life Outcomes, 20, 86. https://doi.org/10.1186/s12955-022-01991-1

Schulman-Green, D., Jaser, S. S., Park, C., & Whittemore, R. (2016). A metasynthesis of factors affecting self-management of chronic illness. Journal of Advanced Nursing, 72, 1469–1489. https://doi.org/10.1111/jan.12902

Setúbal, A. (2023). Endometriose: sintomas, diagnóstico e tratamentos [Endometriosis: symptoms, diagnosis and treatments]. Hospital da Luz. Retrieved from https://www.hospitaldaluz.pt/pt/dicionariode-saude/endometriose-sintomas-tratamentos

Shi, C., Xu, H., Zhang, T., & Gao, Y. (2023). Endometriosis decreases female sexual function and increases pain severity: a meta-analysis. Archives of Gynecology and Obstetrics, 307, 195–204. https://doi.org/10.1007/s00404-022-06478-4

Shum, L. K., Bedaiwy, M. A., Allaire, C., Williams, C., Noga, H., Albert, A., Lisonkova, S., & Yong, P. J. (2018). Deep dyspareunia and sexual quality of life in women with endometriosis. Sexual Medicine, 6, 224–233. https://doi.org/10.1016/j.esxm.2018.04.006

Skalski-Bednarz, S. B., Loichen, T., Toussaint, L., Mendrek, A., Konaszewski, K. & Surzykiewicz, J. (2026). The moderating roles of social support and spirituality in the relationship between complicated grief and quality of life among women who have experienced pregnancy loss. Health Psychology Report, 14, 24–38. https://doi.org/10.5114/hpr/196641

van Eickels, D., Schick, M., Germeyer, A., Rösner, S., Strowitzki, T., Wischmann, T., & Ditzen, B. (2024). Predictors of partnership and sexual satisfaction and dyadic effects in couples affected by endometriosis and infertility. Archives of Gynecology and Obstetrics, 310, 2647–2655. https://doi.org/10.1007/s00404-024-07516-z

Vaz Serra, A., Canavarro, M. C., Simões, M. R., Pereira, M., Gameiro, S., Quartilho, M. J., Carona, C., Rijo, D., & Paredes, T. (2006). Estudos psicométricos do instrumento de avaliação da qualidade de vida da Organização Mundial de Saúde (WHOQOL-Bref) para Português de Portugal [Psychometric studies of the World Health Organization’s quality of life assessment instrument (WHOQOL-Bref) for Portuguese from Portugal]. Psiquiatria Clínica, 27, 41–49.

Vercellini, P., Barbara, G., Buggio, L., Frattaruolo, M. P., Somigliana, E., & Fedele, L. (2012). Effect of patient selection on estimate of reproductive success after surgery for rectovaginal endometriosis: Literature review. Reproductive BioMedicine Online, 24, 389–395. https://doi.org/10.1016/j.rbmo.2012.01.003

WHO (1997). WHOQOL: Measuring quality-of-life. World Health Organization.

WHO (2024). Sexual and reproductive health and research (SRH). Retrieved from https://www.who.int/teams/sexual-and-reproductive-health-andresearch-(srh)/areas-of-work/sexual-health

WHO (2025). Endometriosis. Retrieved from https://www.who.int/news-room/fact-sheets/detail/endometriosis

Wu, Y. H., Lu, Y. Y., & Liu, K. F. (2024). Factors influencing health-related quality of life in women with endometriosis: a cross-sectional study. Nursing & Health Sciences, 26, e13100. https://doi.org/10.1111/nhs.13100

Ziętalewicz, U., & Bargiel-Matusiewicz, K. (2024). Model of quality of life in a group of people with chronic low back pain. Health Psychology Report, 12, 337–351. https://doi.org/10.5114/hpr/185302

Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The Multidimensional Scale of Perceived Social Support. Journal of Personality Assessment, 52, 30–41. https://doi.org/10.1207/s15327752jpa5201_2

Zhu, X., Wu, Y., Jia, J., Zhao, X., & Zhao, X. (2023). Impact of endometriosis on female sexual function: an updated systematic review and meta-analysis. Sexual Medicine, 11, qfad026. https://doi.org/10.1093/sexmed/qfad026

Youseflu, S., Sadatmahalleh, S. J., Khomami, M. B., & Nasiri, M. (2020). Influential factors on sexual function in infertile women with endometriosis: a path analysis. BMC Women’s Health, 20, 92. https://doi.org/10.1186/s12905-020-00941-7

Opublikowane

2026-06-08

Jak cytować

Cacete, N., Pedro, J., Pimenta, F., & Brandão, T. (2026). Quality of life in women with endometriosis in Portugal: a cross-sectional study on the roles of social support and sexual satisfaction. Health Psychology Report, 14(3), 213–222. Pobrano z https://czasopisma.bg.ug.edu.pl/index.php/HPR/article/view/13828

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