Quality of Life Assessment and Clinical Implications for Women with Endometriosis Through Validated Tools: A Narrative Review

Aim: The aim of the study was to synthesize validated patient-reported outcome measures (PROMs) for assessing health-related quality of life (HRQoL) in women with endometriosis and to outline their clinical implications. Methods: We conducted a narrative review of English-language literature indexed in PubMed, Scopus, Web of Science, and Cochrane Library, covering the period 2014-2024, with earlier seminal studies included where relevant. We focused on validated PROMs for QoL but also considered standardized tools such as the Endometriosis Fertility Index (EFI), rASRM, and #Enzian classifications, given their role in clinical interpretation and counseling. Findings: Generic instruments (SF-36, WHOQOL-BREF, EQ-5D), disease-specific tools (EHP-30, EHP-5), and fertility-related questionnaires (FertiQoL, FPI) have demonstrated validity and responsiveness; however, these are inconsistently applied in practice. Knowledge gaps remain regarding routine implementation, timing, and frequency of assessment, and integration with clinical staging or fertility indices (e.g., EFI). Global frameworks such as the WERF EPHect platform facilitate standardized clinical and surgical data capture, though their use is primarily in research rather than routine care. Conclusions: We recommend combining a disease-specific PROM (EHP-30/EHP-5) with a generic instrument (SF-36 or EQ-5D) and adding FertiQoL when fertility is relevant. PROMs should be collected longitudinally (baseline, post-intervention, follow-up) and interpreted alongside clinical context, including pain phenotype, surgical staging (#Enzian/rASRM), and fertility goals. Embedding PROMs into multidisciplinary pathways enables shared decision-making, individualized treatment planning, and improved comparability of patient-centered outcomes.