Psychosomatic comorbidity in endometriosis: A multi-center, cross-sectional study identifying an underestimated factor in current medical support.

OBJECTIVE

Endometriosis affects approximately 10 % of women and is associated with chronic pelvic pain, fatigue, infertility, and impaired quality of life. This study explores the association between psychosomatic diseases/ symptoms and endometriosis.

METHODS

A multi-center study involving 422 women with endometriosis and 422 age-matched control women was conducted in Switzerland, Germany, and Austria. Data was collected using a self-administered questionnaire covering socio-demographic information, health history including psychosomatic diseases, and endometriosis symptoms. Information on endometriosis was extracted from the patients' medical charts.

CLINICALTRIALS: gov NCT02511626.

RESULTS

Psychosomatic diseases/ symptoms but not physiological diseases were associated with a diagnosis of endometriosis. Women with endometriosis reported significantly higher frequencies of pain disorders (migraine/headache (very) often 25.12 %/12.33 %, back pain 32.46 %/16.83 %, chest pain 14.93 %/4.26 %, stomach pain 19.67 %/7.11 %, all p-values <0.001), disturbed mental health (irritability 22.98 %/10.50 %, mood swings 34.59 %/9.48 %, depressive mood 17.33 %/2.81 %, feelings of anxiety 8.29 %/1.42 %, all p-values <0.001), sleeping disorders (33.18 %/11.84 %, p < 0.001), neck tension (50.94 %/34.60 %, p < 0.001), teeth grinding (18.72 %/9.24 % p < 0.04), appetite loss (6.16 %/2.37 %, p < 0.02), digestive problems (31.99 %/11.13 %, p < 0.001), diarrhea (15.17 %/4.50 %, p < 0.001), asthma (3.55 %/0.71 %, p < 0.001), and breathing difficulties (6.16 %/1.19 %, p < 0.10) than did control women. The frequency (≥several times/day 30.47 %/10.58 %, p = 0.013) of endometriosis-related pain was greater in women with psychosomatic comorbidity.

CONCLUSIONS

The study supports a strong association between psychosomatic comorbidity and endometriosis. Pathophysiological mechanisms of this association should be further evaluated to better understand endometriosis development. Endometriosis should be treated with a holistic, multidisciplinary approach, combining physical and psychological aspects to enhance patient outcomes and quality of life.