As we enter Endometriosis Awareness Month, it would be a good idea to shed some light on endometriosis and its effect on mental health in women.
Endometriosis is characterised by the growth of uterine cells which form outside the uterus wall, causing varying levels of inflammation. Endometriosis affects roughly 1 in every 10 women, and is often associated with irregular menstrual cycles, chronic pain, sexual dysfunction and even infertility. Whilst the cause of physical symptoms is generally understood, there is mounting research to suggest that endometriosis is also associated with mental health issues, including increased anxiety and depression.
Whilst the link between endometriosis and mental health issues is still being considered, it comes as no surprise that women who experience symptoms of intense, chronic pain, are far more likely to encounter higher levels of anxiety and depression. This would only be exacerbated by the impact the symptoms of endometriosis would have on functioning, in areas including work, socialising, exercise and intimacy. In addition, women with endometriosis often produce elevated levels of oestrogen and other hormones, which can impact mood, often presenting with increased irritability and frustration.
Whilst chronic pain is the greatest contributor to mental health concerns among women with endometriosis, misdiagnosis or delayed diagnosis of the disease can also lead to increased anxiety and depression in women. On average, there is a 4 – 11 year gap between onset of the disease and official diagnosis. This is, in part, due to the fact that there are no superficial biomarkers for endometriosis, and testing for the disease is both invasive and expensive. It is also often misdiagnosed or misinterpreted, where common misdiagnoses include regular period pain, irritable bowel syndrome and bleeding disorder, which can result in women not receiving the appropriate support and treatment that they need.
Currently, there is no cure for endometriosis, however, there are a range treatments to help manage the symptoms. From a psychological perspective, mindfulness practices, including meditation, relaxation training and yoga, have been shown to be effective in managing chronic pain, as well as decreasing anxiety and depression. This has been shown to be effective in conjunction with cognitive therapies to help reframe negative thought patterns around chronic pain and its impact in daily life.
If you would like to learn more about endometriosis, you can read the articles cited in this blog:
Facchin, G. Barbara, D. Dridi, D. Alberico, L. Buggio, E. Somigliana, E. Saita, P. Vercellini, Mental health in women with endometriosis: searching for predictors of psychological distress, Human Reproduction, Volume 32, Issue 9, September 2017, Pages 1855–1861, https://doi.org/10.1093/humrep/dex249
Delanerolle, G., Ramakrishnan, R., Hapangama, D., Zeng, Y., Shetty, A., Elneil, S., … & Raymont, V. (2021). A systematic review and meta-analysis of the Endometriosis and Mental-Health Sequelae; The ELEMI Project. Women’s Health, 17, 17455065211019717.
Laganà, A. S., La Rosa, V. L., Rapisarda, A. M. C., Valenti, G., Sapia, F., Chiofalo, B., … & Vitale, S. G. (2017). Anxiety and depression in patients with endometriosis: impact and management challenges. International journal of women’s health, 323-330.
