Fertility, pain, and quality of life in women with endometriosis. A population-based Northern Finland birth cohort 1966 study
Thesis event information
Date and time of the thesis defence
Place of the thesis defence
Leena Palotie auditorium, Kontinkangas Campus
Topic of the dissertation
Fertility, pain, and quality of life in women with endometriosis. A population-based Northern Finland birth cohort 1966 study
Doctoral candidate
Medical Doctor Saara Vuontisjärvi
Faculty and unit
University of Oulu Graduate School, Faculty of Medicine, Medical Research Center Oulu
Subject of study
Medicine
Opponent
Professor Andrew Horne, University of Edinburgh
Custos
Professor Terhi Piltonen, University of Oulu
Fertility, pain, and quality of life in women with endometriosis
Endometriosis is a chronic condition affecting around 10% of women of
reproductive age and is defined by the presence of endometrial tissue outside the uterine cavity. The condition is estrogen-dependent and has multifaceted symptoms, including dysmenorrhea, non-menstrual pelvic pain, dyspareunia, infertility, and fatigue. Endometriosis is also known to affect quality of life.
This thesis aimed to examine lifelong fertility and number of deliveries in
women with endometriosis. Another aim was to assess the effects of
endometriosis on pain perception and pain threshold in women at age 46. Lastly, the study examined the association between endometriosis and health-related quality of life (HRQoL) in women with endometriosis at ages 31 and 46 years.
The study population was drawn from the Northern Finland Birth Cohort 1966 (NFBC1966) with data linkage to the national registers.
The results indicated that women with endometriosis experience threefold odds of decreased fecundability, and they have fewer children by age 48 when compared with women without the disease (1.96 vs 2.35). However, affected women have a good prognosis for having their first child at a similar age as women without endometriosis if they attend infertility treatments.
Pain perception was found to be altered in women with endometriosis up to age 46 years. Their pressure-pain sensitivity and maximal pain tolerance were lower, and they had more often widespread and disturbing pain when compared with women without the condition.
The affected women had lower HRQoL at ages 31 and 46 than the reference group. Domains that were affected at 31 were ‘sleeping’, ‘depression’ and ‘distress’, whereas at age 46 ‘sleeping’ was impaired. The results also suggest that infertility, depression, pain and poor general health contribute to worsening HRQoL.
In summary, these studies show that endometriosis affects fertility, pain
perception, and HRQoL, and that traits related to pain and HRQoL persist into late fertile age, even though endometriosis is usually considered a disease of reproductive age. The need for comprehensive information on the condition’s effects, a holistic management approach, and psychological support at diagnosis is evident.
reproductive age and is defined by the presence of endometrial tissue outside the uterine cavity. The condition is estrogen-dependent and has multifaceted symptoms, including dysmenorrhea, non-menstrual pelvic pain, dyspareunia, infertility, and fatigue. Endometriosis is also known to affect quality of life.
This thesis aimed to examine lifelong fertility and number of deliveries in
women with endometriosis. Another aim was to assess the effects of
endometriosis on pain perception and pain threshold in women at age 46. Lastly, the study examined the association between endometriosis and health-related quality of life (HRQoL) in women with endometriosis at ages 31 and 46 years.
The study population was drawn from the Northern Finland Birth Cohort 1966 (NFBC1966) with data linkage to the national registers.
The results indicated that women with endometriosis experience threefold odds of decreased fecundability, and they have fewer children by age 48 when compared with women without the disease (1.96 vs 2.35). However, affected women have a good prognosis for having their first child at a similar age as women without endometriosis if they attend infertility treatments.
Pain perception was found to be altered in women with endometriosis up to age 46 years. Their pressure-pain sensitivity and maximal pain tolerance were lower, and they had more often widespread and disturbing pain when compared with women without the condition.
The affected women had lower HRQoL at ages 31 and 46 than the reference group. Domains that were affected at 31 were ‘sleeping’, ‘depression’ and ‘distress’, whereas at age 46 ‘sleeping’ was impaired. The results also suggest that infertility, depression, pain and poor general health contribute to worsening HRQoL.
In summary, these studies show that endometriosis affects fertility, pain
perception, and HRQoL, and that traits related to pain and HRQoL persist into late fertile age, even though endometriosis is usually considered a disease of reproductive age. The need for comprehensive information on the condition’s effects, a holistic management approach, and psychological support at diagnosis is evident.
Created 12.11.2026 | Updated 13.11.2026