Introduction
The Endometriosis Health Profile-30 (EHP-30) is a disease-specific, patient-generated questionnaire that measures health-related quality of life in women with endometriosis. Georgina Jones, Stephen Kennedy, Angela Barnard, Josephine Wong and Crispin Jenkinson published it in 2001 in Obstetrics & Gynecology, and it has received more than 560 citations.
The EHP-30 captures the physical, psychological and social areas that women with endometriosis consider important. This guide explains its five core scales, optional modules, scoring and evidence.
Key Features of the Endometriosis Health Profile-30 (EHP-30)
Purpose and Use
The EHP-30 shows how endometriosis and its treatments affect women's daily lives and well-being from the patient's perspective. Its authors intended it for use in a range of health care settings, including evaluating the effect of treatments on quality of life.
Target Population
The EHP-30 is intended for adult women with endometriosis.
Structure
The core questionnaire has 30 items in five scales identified by factor analysis:
Core scale
What it covers
Items
Pain
Coping, daily and household activities, standing, sitting, walking, sleep, exercise and leisure, appetite and social events
11
Control and Powerlessness
Feeling unwell, frustration with persistent, uncontrollable symptoms, and symptoms dominating life
6
Emotional Well-being
Depression, tearfulness, misery, mood swings, short temper and aggression
6
Social Support
Difficulty telling others, loneliness, feeling misunderstood and feeling seen as complaining
5
Self-image
Clothing choices, appearance and confidence
3
An optional 23-item modular questionnaire can be added when relevant, with six modules: work (5 items), sexual intercourse (5), relationship with children (2), feelings about the medical profession (4), treatment (3) and infertility (4).
Scoring Method
Items are answered for the last 4 weeks on a 5-point scale: never, rarely, sometimes, often and always, scored 0 to 4.
Scale scores: sum the item scores in each scale, divide by the maximum possible raw score for that scale and multiply by 100.Range: each scale runs from 0 (best health status) to 100 (worst).No total: each scale is scored separately; there is no single total score and no cut-off.Administration Format
The EHP-30 is a self-report questionnaire and can be administered electronically (eCOA).
Applications of the Endometriosis Health Profile-30 (EHP-30)
The EHP-30 supports several uses:
Treatment evaluation: measuring the effect of treatments on health-related quality of life.Clinical research and trials: a standard outcome measure in endometriosis studies.Clinical care: showing how endometriosis affects a woman's daily life.Languages and availability
The EHP-30 is available in many languages, with published validations including:
Simplified Chinese: translation and psychometric evaluationSpanish: evaluation studyFrench: psychometric propertiesPortuguese: validation of the Portuguese versionMalay: psychometric propertiesPersian: reliability and validitySwedish: psychometric evaluationTurkish: validation studyRussian and German: official translations are available from Oxford University Innovation; a German evaluation project reported good reliability and validityThe EHP-30 is owned and licensed by Oxford University Innovation, and licensing fees may apply.
Reliability and Validity
The original development study reported:
Test–retest reliability: high for all scales after 3–6 days (intraclass correlations 0.88 to 0.98), although the self-image scale differed significantly between the two time pointsContent validity: items were generated from in-depth interviews with 25 women with endometriosisConstruct validity: significant correlations with matching SF-36 scales (Spearman r -0.41 to -0.73; negative because the two are scored in opposite directions)Factor structure: derived by principal component analysis in 325 womenValidation studies:
Development of an endometriosis quality-of-life instrument: the Endometriosis Health Profile-30 (2001): study linkPsychometric evaluation of the Swedish EHP-30 (2020): study linkValidation of the Turkish EHP-30 (2023): study linkA systematic review of the use of the Endometriosis Health Profiles, by the developers (2023): study linkLimitations and Considerations
Keep these points in mind:
Licensing: users need a licence from Oxford University Innovation, and licensing costs may apply.Translations: cross-cultural validity may be an issue in some translated versions.Self-image stability: the self-image scale changed significantly between test and retest.No total or cut-offs: scales are reported separately, and no cut-off values exist.Other Versions And Related Questionnaires
The Endometriosis Health Profile-5 (EHP-5) is a short form published in 2004.
These questionnaires are related:
Nottingham Health Profile (NHP)Short Form-36 Health Survey (SF-36)Short Form-12 Health Survey (SF-12)Additional Resources
The original article: linkTo request a licence, contact Oxford University Innovation at enquiries@innovation.ox.ac.uk or through its EHP licence page.Browse more obstetrics and gynecology questionnaires in the ResRef database.Frequently Asked Questions (FAQ)
What does the Endometriosis Health Profile-30 measure?The EHP-30 measures health-related quality of life in women with endometriosis across five core scales: pain, control and powerlessness, emotional well-being, social support and self-image.
How is the EHP-30 scored?Items are scored 0 (never) to 4 (always) for the last 4 weeks. Each scale's total is divided by its maximum possible score and multiplied by 100, giving 0 (best) to 100 (worst).
Is there a short version of the EHP-30?Yes. The Endometriosis Health Profile-5 (EHP-5) is a short form published in 2004. The EHP-30 can also be extended with a 23-item modular questionnaire.
Is the EHP-30 free to use?No. The EHP-30 is owned and licensed by Oxford University Innovation, so users need to request a licence, and licensing costs may apply.
A Word from ResRef About the Endometriosis Health Profile-30 (EHP-30)
The EHP-30 is the gold-standard, patient-generated instrument for measuring health-related quality of life in women with endometriosis. Its rigorous development and extensive validation across numerous languages make it an essential tool for clinical research and trials. However, users must be aware of the licensing costs and the potential for cross-cultural validity issues in some translated versions.
References
Jones, G., Kennedy, S., Barnard, A., Wong, J., & Jenkinson, C. (2001). Development of an endometriosis quality-of-life instrument: The Endometriosis Health Profile-30. Obstetrics & Gynecology, 98(2), 258–264. https://doi.org/10.1016/s0029-7844(01)01433-8Jia, S., Leng, J., Sun, P., & Lang, J. (2012). Translation and psychometric evaluation of the simplified Chinese-version Endometriosis Health Profile-30. Human Reproduction, 28(3), 691–697. https://doi.org/10.1093/humrep/des426Mansor, M., Chong, M. C., Chui, P. L., Hamdan, M., & Basha, M. A. M. K. (2023). The psychometric properties test of the Malay version of the endometriosis health profile-30. Saudi Medical Journal, 44(9), 933–939. https://doi.org/10.15537/smj.2023.44.9.20230228Nojomi, M., Bijari, B., Akhbari, R., & Kashanian, M. (2011). The Assessment of Reliability and Validity of Persian Version of the Endometriosis Health Profile (EHP-30). Iranian Journal of Medical Sciences, 36(2), 84–9. https://pubmed.ncbi.nlm.nih.gov/23358588/Nogueira-Silva, C., Costa, P., Martins, C., Barata, S., Alho, C., Calhaz-Jorge, C., & Osório, F. (2015). Validação da Versão Portuguesa do Questionário EHP-30 (The Endometriosis Health Profile-30). Acta Médica Portuguesa, 28(3), 347–356. https://doi.org/10.20344/amp.5778Marí-Alexandre, J., García-Oms, J., Agababyan, C., Belda-Montesinos, R., Royo-Bolea, S., Varo-Gómez, B., Díaz-Sierra, C., González-Cantó, E., & Gilabert-Estellés, J. (2022). Toward an improved assessment of quality of life in endometriosis: evaluation of the Spanish version of the Endometriosis Health Profile 30. Journal of Psychosomatic Obstetrics and Gynaecology, 43(3), 251–257. https://doi.org/10.1080/0167482X.2020.1795827Chauvet, P., Auclair, C., Mourgues, C., Canis, M., Gerbaud, L., & Bourdel, N. (2017). Psychometric properties of the French version of the Endometriosis Health Profile-30, a health-related quality of life instrument. Journal of Gynecology Obstetrics and Human Reproduction, 46(3), 235–242. https://doi.org/10.1016/j.jogoh.2017.02.004Grundström, H., Rauden, A., Wikman, P., & Olovsson, M. (2020). Psychometric evaluation of the Swedish version of the 30-item endometriosis health profile (EHP-30). BMC Women's Health, 20(1). https://doi.org/10.1186/s12905-020-01067-6Darici, E., Kemahlı, M. N. C., Bahat, P. Y., Yücel, B., & Oral, E. (2023). Validation of the Turkish version of Endometriosis Health Profile questionnaire (EHP-30) to evaluate the quality of life in women with endometriosis. Facts, Views and Vision in ObGyn, 15(2), 131–136. https://doi.org/10.52054/fvvo.15.2.079Jones, G. L., Budds, K., Taylor, F., Musson, D., Raymer, J., Churchman, D., Kennedy, S. H., & Jenkinson, C. (2023). A systematic review to determine use of the Endometriosis Health Profiles to measure quality of life outcomes in women with endometriosis. Human Reproduction Update, 30(2), 186–214. https://doi.org/10.1093/humupd/dmad029