Psychological burdens of endometriosisA large number of studies prove that endometriosis not only brings physical symptoms, but also represents a considerable psychological burden for affected persons. For example, the quality of life of those affected is often reduced and their stress levels are increased [3, 4, 9, 10, 17]. It is important to note that endometriosis is not a psychosomatic disease and is not triggered by psychological problems. It means that those affected have to deal with more stress in everyday life than healthy women. These stresses are not imaginary, but very real and affect many aspects of life. And unfortunately, it can promote some mental illnesses, so that they occur more frequently than in healthy women. This makes it all the more important for the health care system to consciously address these burdens of.
Causes – Burden of symptoms
An initial burden is the often long period of Insecurity up to the point of diagnosis. The average time from symptom onset to diagnosis varies from 5 to 9 years in studies . Longer waiting times until diagnosis are associated with a reduced quality of life.
In addition, various influencing factors play a role. Especially due to frequent Pain the quality of life of women with endometriosis is limited [3,4]. In addition to pain, endometriosis brings with it other symptoms that make everyday life more difficult. Thus, 50-70% of women with endometriosis suffer from a Fatigue – i.e. a strong and limiting fatigue. Approximately half of those affected also report Sleep Disorders . Sleep disturbances, in turn, can reduce quality of life and energy levels.
Endometriosis symptoms such as abdominal pain and pain during sexual intercourse can affect the Sexuality significantly affect the lives of those affected [5, 15. Studies have indeed found a reduced frequency of sexual activity. The more severe the pain, the lower the sexual satisfaction [18,21]. In turn, problems with sexuality can reduce quality of life and have a negative impact on partnership [5,13]. Then, in a study of 931 women, 50% of them also reported that endometriosis affects their relationship . Pain during sexual intercourse plays a role , as does a reduced interest in sexuality and bleeding during sexual intercourse, involuntary childlessness, Mood swings and fatigue . Not only affected women themselves, but also their partners feel affected by the disease .
Causes – stress due to effects of the disease
The disease can generally lead to Problems in the social environment lead to [5, 15]. Between 19 and 48% of affected individuals feel restricted in their social life and social activities [3,8]. In addition, affected women perceive a stigmatization of the disease and are therefore reluctant to talk about their disease in their environment .
Similarly, the Self-esteem and the Body image Be impaired in endometriosis sufferers [6,11]. However, little research is yet available on this topic.
Last, endometriosis can Performance and work life be impaired. In one study, about half of the respondents reported that endometriosis had affected their work life . In another study of 810 endometriosis sufferers, they reported decreased productivity . On average, they lost 1.1 hours a week due to absenteeism at work and 5.3 hours due to reduced performance at work. In their personal lives, they missed an average of 2.5 hours of work at home, and lost 2.3 hours due to decreased performance at work. In another study, they lost 10.8 hours of productive time per week for health reasons, significantly more time than healthy women. The more severe the endometriosis and its symptoms were, the decreased productivity was . As a result, endometriosis can also represent a significant financial burden.
Frequency of mental illness
With these multiple stresses that endometriosis can bring, it is not surprising that it is associated with an increased risk of mental illnesses such as depression and anxiety disorders. Although this relationship is well established, the actual prevalence of psychological symptoms in endometriosis sufferers is still unclear. Existing studies do not provide a consistent picture [1, 2, 17].
Basically, pain seems to play an important role in this process. For example, one study found that depression affected 38% of women without chronic lower abdominal pain, compared with 86% of those with chronic lower abdominal pain . Consistent with this, in another study, of 104 women with endometriosis surveyed, 86.5% had varying degrees of depressive symptoms and 87.5% had varying degrees of anxiety. Pain severity correlated with anxiety symptoms, whereas no association was found between endometriosis stage and mental health .
More pain – more psychological distress and illness
Thus, the severity of pain appears to be a determining factor. This fits with the results of a survey of 57 endometriosis patients, in which chronic lower abdominal pain was again associated with reduced quality of life and increased psychological problems, and endometriosis no longer had any additional impact on quality of life beyond pain . When women with chronic pain due to endometriosis were compared with women who suffered from chronic abdominal pain due to other conditions, no differences were found with respect to depressive symptoms and emotional distress .
Overall, it appears that women with endometriosis and associated pain report more anxiety and depressive symptoms than do healthy women and women without pain.
Further research in this area is needed, yet previous studies already indicate a vicious cycle in that psychological problems, daily stresses, and pain are mutually reinforcing in endometriosis patients [5,9,17]. Endometriosis as a disease brings with it many stresses that can cause psychological distress. Cause psychological discomfort Not the endometriosis, but can act as a vicious cycle of pre-existing pain and problems such as.B. Increase partner conflicts.
In summary, endometriosis can affect all aspects of affected individuals' lives: Work, leisure, sexuality and partnership, social relationships, self-esteem and mental health. In particular, pain seems to be in a vicious cycle socially. Increasing psychological stress. Therefore, multidisciplinary treatment is essential, not only paying attention to the medical aspects, but providing comprehensive support to affected individuals. These include u.a. Exercise therapy, nutritional counseling, physiotherapy, psychological therapies, meditation and relaxation. Nevertheless, further research is needed in this area to provide affected individuals with the best possible treatment in the future.