A psychosomatic perspective on endometriosis – a mini review

Purpose: Endometriosis is an extremely disabling and long-term medical condition, characterized by the presence of endometrial-like tissue outside the uterus, usually manifesting as cramping, menstrual and ovulation pain, lower abdominal and/or pelvic pain, chronic fatigue, dyspareunia, and infertility. Endometriosis is often co-morbid with psychological distress that worsens the quality-of-life of affected women. Methods: The main aim was to review the current evidence about the management of endometriosis from a psychosomatic perspective. The literature was synthesized and summarized in a narrative format. The literature search was conducted using PubMed, based on reports, review articles, meta-analysis, overviews and guidelines published in English in the last 15 years. Results: Five main topics are covered and discussed: pathogenesis of endometriosis, endometriosis and psychological features, endometriosis and psychiatric comorbidity, early life stress as predisposing factor for pain sensitization; and implications for treatment. Conclusions: The available literature clearly emphasizes that it is important to consider and to treat the comorbidity of endometriosis with psychological factors that affect pain management.