THE CORRELATION BETWEEN ENDOMETRIOSIS PAIN, MENTAL HEALTH DISORDERS, AND QUALITY OF LIFE IMPACT

Marta Zgierska; Natalia Pacocha; Jakub Jędrychowski; Justyna Popczyńska; Natalia Karpowicz; Małgorzata Krzyżanowska; Julia Kaszucka; Agnieszka Raczyńska; Kinga Kosiec; Oliwia Krzemień

doi:10.31435/rsglobal_ijitss/30062024/8152

Marta Zgierska Faculty of Medicine, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warszawa, Poland https://orcid.org/0009-0007-4472-0631
Natalia Pacocha Faculty of Medicine, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warszawa, Poland https://orcid.org/0009-0001-3370-9521
Jakub Jędrychowski Faculty of Medicine, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warszawa, Poland https://orcid.org/0009-0002-8496-292X
Justyna Popczyńska Faculty of Medicine, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warszawa, Poland https://orcid.org/0009-0008-7654-932X
Natalia Karpowicz Faculty of Medicine, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warszawa, Poland https://orcid.org/0009-0003-6287-5777
Małgorzata Krzyżanowska Faculty of Medicine, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warszawa, Poland https://orcid.org/0009-0003-6287-5777
Julia Kaszucka Faculty of Medicine, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warszawa, Poland https://orcid.org/0000-0002-9017-3604
Agnieszka Raczyńska Faculty of Medicine, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warszawa, Poland https://orcid.org/0000-0002-0423-3325
Kinga Kosiec Faculty of Medicine, Medical University of Gdańsk, Marii Skłodowskiej-Curie 3a, 80- 210 Gdańsk, Poland https://orcid.org/0009-0008-8756-3012
Oliwia Krzemień Faculty of Medicine, Medical University of Gdańsk,, Marii Skłodowskiej-Curie 3a, 80- 210 Gdańsk, Poland https://orcid.org/0009-0003-1863-3025

DOI: https://doi.org/10.31435/rsglobal_ijitss/30062024/8152

Keywords: Climate Change, Extreme Precipitation Events, Statistical Analysis, Semi-Arid Climate

Abstract

Introduction: Endometriosis ranks among the prevalent gynecological conditions, impacting approximately 10% of women during their reproductive years. Primarily characterized by pain, endometriosis is also associated with several psychiatric comorbidities such as anxiety, depression and eating disorders. Research also demonstrates a significant decline in the quality of life among patients.

The objective of this study is to undertake an exhaustive literature review on endometriosis in women, with a specific focus on understanding its effects on mental health and quality of life.

Material and methods: We conducted a literature review utilizing the resources available in the "PubMed" database. The search was performed using following keywords: endometriosis; pelvic pain; anxiety; depression; mental health; eating disorders.

Discussion: Research indicates that women diagnosed with endometriosis, particularly those experiencing pain, exhibit elevated stress levels and a diminished quality of life compared to women without the condition. Importantly, depression and anxiety are more prevalent in women with endometriosis, and the presence of psychiatric disorders correlates more to the severity of the endometriosis-related pain than to other disease characteristics. In terms of treatment implications, clinical trials have shown that both medical and surgical interventions for endometriosis not only alleviate physical symptoms but also improve perceived stress, anxiety, and depressive symptoms.

Conclusions: We found that severe endometriosis-related pain and the presence of psychiatric disorders were linked to reduced quality of life. Ensuring holistic care for endometriosis is essential for enhancing patients' quality of life. Furthermore, effectively treating endometriosis can alleviate the psychological strain it imposes.

References

Laganà, A. S., La Rosa, V. L., Rapisarda, A. M. C., Valenti, G., Sapia, F., Chiofalo, B., Rossetti, D., Ban Frangež, H., Vrtačnik Bokal, E., & Giovanni Vitale, S. (2017). Anxiety and depression in patients with endometriosis: impact and management challenges. International Journal of Women's Health, 9, 323–330. https://doi.org/10.2147/IJWH.S130616.

Casalechi, M., Vieira-Lopes, M., Quessada, M. P., Arão, T. C., & Reis, F. M. (2021). Endometriosis and related pelvic pain: association with stress, anxiety and depressive symptoms. Minerva Obstetrics and Gynecology, 73(3). https://doi.org/10.23736/s2724-606x.21.04704-3.

Facchin, F., Barbara, G., Saita, E., Mosconi, P., Roberto, A., Fedele, L., & Vercellini, P. (2015). Impact of endometriosis on quality of life and mental health: pelvic pain makes the difference. Journal of Psychosomatic Obstetrics & Gynecology, 36(4), 135–141. https://doi.org/10.3109/0167482X.2015.1096773.

Koller, D., Pathak, G. A., Wendt, F. R., Tylee, D. S., Levey, D. F., Overstreet, C., Gelernter, J., Taylor, H. S., & Polimanti, R. (2023). Epidemiologic and Genetic Associations of Endometriosis With Depression, Anxiety, and Eating Disorders. Obstetrical & Gynecological Survey, 78(5), 282–283. https://doi.org/10.1097/01.ogx.0000935848.53207.07.

Škegro, B., Bjedov, S., Mikuš, M., Mustač, F., Lešin, J., Matijević, V., Ćorić, M., Elveđi Gašparović, V., Medić, F., & Sokol Karadjole, V. (2021). Endometriosis, Pain and Mental Health. Psychiatria Danubina, 33(Suppl 4), 632–636.

Aubry, G., Panel, P., Thiollier, G., Huchon, C., & Fauconnier, A. (2017). Measuring health-related quality of life in women with endometriosis: comparing the clinimetric properties of the Endometriosis Health Profile-5 (EHP-5) and the EuroQol-5D (EQ-5D). Human Reproduction, 32(6), 1258–1269. https://doi.org/10.1093/humrep/dex057.

Nassiri Kigloo, H., Itani, R., Montreuil, T., Feferkorn, I., Raina, J., Tulandi, T., Mansour, F., Krishnamurthy, S., & Suarthana, E. (2024). Endometriosis, chronic pain, anxiety, and depression: A retrospective study among 12 million women. Journal of Affective Disorders, 346, 260–265. https://doi.org/10.1016/j.jad.2023.11.034.

Zippl, A. L., Reiser, E., & Seeber, B. (2023). Endometriosis and Mental Health Disorders: identification and treatment as part of a multimodal approach. Fertility and Sterility. https://doi.org/10/1016/j.fertnstert.2023.12.033.

Delanerolle, G., Ramakrishnan, R., Hapangama, D., Zeng, Y., Shetty, A., Elneil, S., Chong, S., Hirsch, M., Oyewole, M., Phiri, P., Elliot, K., Kothari, T., Rogers, B., Sandle, N., Haque, N., Pluchino, N., Silem, M., O'Hara, R., Hull, M. L., Majumder, K., … Raymont, V. (2021). A systematic review and meta-analysis of the Endometriosis and Mental-Health Sequelae; The ELEMI Project. Women's health (London, England), 17, 17455065211019717. https://doi.org/10.1177/17455065211019717.

World Health Organization. (2023, March 24). Endometriosis. Retrieved from https://www.who.int/newsroom/fact-sheets/detail/endometriosis.

Mallorquí, A., Martínez-Zamora, M. A., & Carmona, F. (2022). Anhedonia in endometriosis: An unexplored symptom. Frontiers in psychology, 13, 935349. https://doi.org/10.3389/fpsyg.2022.935349.

Panariello, F., Borgiani, G., Bronte, C., Cassero, G., Montanari, G., Falcieri, M., Rugo, M. A., Trunfio, O., De Ronchi, D., & Atti, A. R. (2023). Eating disorders and disturbed eating behaviors underlying body weight differences in patients affected by endometriosis: Preliminary results from an Italian cross-sectional study. International Journal of Environmental Research and Public Health, 20(3), 1727. https://doi.org/10.3390/ijerph20031727.

Sullivan-Myers, C., Sherman, K. A., Beath, A. P., Cooper, M. J. W., & Duckworth, T. J. (2023). Body image, self-compassion, and sexual distress in individuals living with endometriosis. Journal of psychosomatic research, 167, 111197. https://doi.org/10.1016/j.jpsychores.2023.111197.

van Barneveld, E., Manders, J., van Osch, F. H. M., van Poll, M., Visser, L., van Hanegem, N., Lim, A. C., Bongers, M. Y., & Leue, C. (2022). Depression, Anxiety, and Correlating Factors in Endometriosis: A Systematic Review and Meta-Analysis. Journal of women's health (2002), 31(2), 219–230. https://doi.org/10.1089/jwh.2021.0021.

Dior, U. P., Reddington, C., Cheng, C., Levin, G., & Healey, M. (2022). Sexual Function of Women With Deep Endometriosis Before and After Surgery: A Prospective Study. The journal of sexual medicine, 19(2), 280–289. https://doi.org/10.1016/j.jsxm.2021.11.009.

Sullivan, M. J., Thorn, B., Haythornthwaite, J. A., Keefe, F., Martin, M., Bradley, L. A., & Lefebvre, J. C. (2001). Theoretical perspectives on the relation between catastrophizing and pain. The Clinical journal of pain, 17(1), 52–64. https://doi.org/10.1097/00002508-200103000-00008.

Martin, C. E., Johnson, E., Wechter, M. E., Leserman, J., & Zolnoun, D. A. (2011). Catastrophizing: a predictor of persistent pain among women with endometriosis at 1 year. Human reproduction (Oxford, England), 26(11), 3078–3084. https://doi.org/10.1093/humrep/der292.

Laganà, A. S., Garzon, S., Götte, M., Viganò, P., Franchi, M., Ghezzi, F., & Martin, D. C. (2019). The Pathogenesis of Endometriosis: Molecular and Cell Biology Insights. International journal of molecular sciences, 20(22), 5615. https://doi.org/10.3390/ijms20225615.

National Guideline Alliance (UK). (2017). Endometriosis: Diagnosis and Management. London: National Institute for Health and Care Excellence (NICE).

La Rosa, V. L., Barra, F., Chiofalo, B., Platania, A., Di Guardo, F., Conway, F., Di Angelo Antonio, S., & Lin, L. T. (2020). An overview on the relationship between endometriosis and infertility: the impact on sexuality and psychological well-being. Journal of psychosomatic obstetrics and gynaecology, 41(2), 93–97. https://doi.org/10.1080/0167482X.2019.1659775.

Chen, L. C., Hsu, J. W., Huang, K. L., Bai, Y. M., Su, T. P., Li, C. T., Yang, A. C., Chang, W. H., Chen, T. J., Tsai, S. J., & Chen, M. H. (2016). Risk of developing major depression and anxiety disorders among women with endometriosis: A longitudinal follow-up study. Journal of affective disorders, 190, 282–285. https://doi.org/10.1016/j.jad.2015.10.030.

Estes, S. J., Huisingh, C. E., Chiuve, S. E., Petruski-Ivleva, N., & Missmer, S. A. (2021). Depression, Anxiety, and Self-Directed Violence in Women With Endometriosis: A Retrospective Matched-Cohort Study. American journal of epidemiology, 190(5), 843–852. https://doi.org/10.1093/aje/kwaa249.

Facchin, F., Buggio, L., Roncella, E., Somigliana, E., Ottolini, F., Dridi, D., Roberto, A., & Vercellini, P. (2021). Sleep disturbances, fatigue and psychological health in women with endometriosis: a matched pair case-control study. Reproductive biomedicine online, 43(6), 1027–1034. https://doi.org/10.1016/j.rbmo.2021.08.011.

Mundo-López, A., Ocón-Hernández, O., San-Sebastián, A. P., Galiano-Castillo, N., Rodríguez-Pérez, O., Arroyo-Luque, M. S., Arroyo-Morales, M., Cantarero-Villanueva, I., Fernández-Lao, C., & Artacho-Cordón, F. (2020). Contribution of Chronic Fatigue to Psychosocial Status and Quality of Life in Spanish Women Diagnosed with Endometriosis. International journal of environmental research and public health, 17(11), 3831. https://doi.org/10.3390/ijerph17113831.

Taylor, H. S., Kotlyar, A. M., & Flores, V. A. (2021). Endometriosis is a chronic systemic disease: clinical challenges and novel innovations. Lancet (London, England), 397(10276), 839–852. https://doi.org/10.1016/S0140-6736(21)00389-5.

Spagnolo, E., Zannoni, L., Raimondo, D., Ferrini, G., Mabrouk, M., Benfenati, A., Villa, G., Bertoldo, V., & Seracchioli, R. (2014). Urodynamic evaluation and anorectal manometry pre- and post-operative bowel shaving surgical procedure for posterior deep infiltrating endometriosis: a pilot study. Journal of minimally invasive gynecology, 21(6), 1080–1085. https://doi.org/10.1016/j.jmig.2014.05.012.

Facchin, F., Barbara, G., Saita, E., Mosconi, P., Roberto, A., Fedele, L., & Vercellini, P. (2015). Impact of endometriosis on quality of life and mental health: pelvic pain makes the difference. Journal of psychosomatic obstetrics and gynaecology, 36(4), 135–141. https://doi.org/10.3109/0167482X.2015.1074173.

Bergqvist, A., & Theorell, T. (2001). Changes in quality of life after hormonal treatment of endometriosis. Acta obstetricia et gynecologica Scandinavica, 80(7), 628–637.

Bedaiwy, M. A., Allaire, C., Yong, P., & Alfaraj, S. (2017). Medical Management of Endometriosis in Patients with Chronic Pelvic Pain. Seminars in reproductive medicine, 35(1), 38–53. https://doi.org/10.1055/s-0036-1597308.

Zhao, L., Wu, H., Zhou, X., Wang, Q., Zhu, W., & Chen, J. (2012). Effects of progressive muscular relaxation training on anxiety, depression and quality of life of endometriosis patients under gonadotrophin-releasing hormone agonist therapy. European journal of obstetrics, gynecology, and reproductive biology, 162(2), 211–215. https://doi.org/10.1016/j.ejogrb.2012.02.029.