{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T23:26:17Z","timestamp":1793057177574,"version":"4.5.0"},"reference-count":39,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T00:00:00Z","timestamp":1736208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Endometriosis is a chronic gynecological disorder characterized by ectopic endometrial-like tissue. The symptoms of this disease negatively affect the patient\u2019s quality of life, both physically and mentally. This study aims to identify key factors impacting health-related quality of life in endometriosis patients. Methods: A total of 175 patients from the Endometriosis Centre of the RWTH Aachen University Hospital were assessed using the German version of the EHP-30. The EHP is a patient self-report tool used to measure the wide range of impacts that endometriosis can have on women\u2019s lives (affecting pain levels, leading to feelings of powerlessness and a loss of control, and affecting their emotional well-being, social support, and self-image). Multivariate linear regression and random forest analyses were performed to evaluate predictors of health-related quality of life, focusing on demographic characteristics, pain severity, endometriosis symptoms and planned procedures. Results: Key factors that have a significant negative impact on QoL include higher pain scores, dysuria, and persistent endometriosis. Higher pain scores negatively affect the EHP-30 pain (p &lt; 0.0001), control and powerlessness (p &lt; 0.0001) and emotional well-being (p &lt; 0.01) scores. Dysuria has a negative effect on pain (p &lt; 0.001), control and powerlessness (p &lt; 0.001), emotional well-being (p &lt; 0.05), and social support (p &lt; 0.05). Persistent endometriosis was negatively associated with pain (p &lt; 0.01), control and powerlessness (p &lt; 0.01), and social support. Previous endometriosis surgery has a positive effect on the EHP-30 scores for pain, control and powerlessness, emotional well-being, and self-image (p &lt; 0.05). Conclusions: Our study highlights the multifactorial impact of endometriosis on health-related QoL. Personalized treatments focusing on pain management, emotional support and social interventions are crucial to improve patient outcomes.<\/jats:p>","DOI":"10.3390\/jcm14020323","type":"journal-article","created":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T07:42:19Z","timestamp":1736235739000},"page":"323","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["The Multifactorial Burden of Endometriosis: Predictors of Quality of Life"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0629-8576","authenticated-orcid":false,"given":"Tomas","family":"Kupec","sequence":"first","affiliation":[{"name":"Department of Gynecology and Obstetrics, University Hospital RWTH Aachen, 52074 Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lieven Nils","family":"Kennes","sequence":"additional","affiliation":[{"name":"Department of Economics and Business Administration, University of Applied Sciences Stralsund, Zur Schwedenschanze 15, 18435 Stralsund, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Senger","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, University Hospital RWTH Aachen, 52074 Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9853-0004","authenticated-orcid":false,"given":"Philipp","family":"Meyer-Wilmes","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, University Hospital RWTH Aachen, 52074 Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2102-623X","authenticated-orcid":false,"given":"Laila","family":"Najjari","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, University Hospital RWTH Aachen, 52074 Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9715-7260","authenticated-orcid":false,"given":"Elmar","family":"Stickeler","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, University Hospital RWTH Aachen, 52074 Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1841-4207","authenticated-orcid":false,"given":"Julia","family":"Wittenborn","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, University Hospital RWTH Aachen, 52074 Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1038\/nrendo.2013.255","article-title":"Endometriosis: Pathogenesis and treatment","volume":"10","author":"Vercellini","year":"2014","journal-title":"Nat. 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