Psychosocial impact of endometriosis

A peculiar, couple-centered, multimodal procedure, integrating psychosexual and medical management for endometriosis, is optimal.

Key Points

Highlights:

• Chronic endometriosis-associated pain has a detrimental impact on the psychosocial adjustment and sexual function of afflicted women and their partners.

Importance

• An individualized, couple-centered biopsychosocial approach, involving a multidisciplinary team comprising gynecologists, sexologists, psychologists/psychotherapists, and physiotherapists, is pivotal in the treatment of endometriosis.

What’s done here:

• Researchers from Switzerland conducted a review to outline the consequences of endometriosis on the psychological, sexual, and interpersonal functioning of both patients and their partners.
• Treatment approaches from medical, psychosocial, and integrated perspectives; and recommendations for future research are suggested.

Key results:

• Endometriosis has four significant consequences: psychological, sexual, relationship, and social.
• Women with endometriosis report higher psychological distress, including higher levels of pain catastrophizing, stress, more depression, and anxiety.
• Endometriosis appears to have an impact on all domains of sexual function - desire/arousal, orgasm, satisfaction, and pain; leading to sexual dysfunction and distress in 70-75% of patients.
  • Male partners of women with endometriosis suffer from consequences of their partner's pain, showing increased rates of further psychological distress.
  • 67% of women with affected relationships declared significant problems with their partner mainly caused by endometriosis.
• Endometriosis symptoms have a detrimental impact on daily life and physical functioning. Between 16% and 61% of women experience difficulties with mobility, daily activities, and self-care.
• Future research needs to expand on research methodologies, should include prospective and longitudinal studies and explore all aspects of sexual well-being, the different coping strategies, and the consequences of infertility.
• Treatment for endometriosis must include a multidisciplinary team comprising gynecologists, sexologists, psychologists/psychotherapists, and physiotherapists.

Lay Summary

In this review article, researchers from Switzerland report a review to outline the consequences of endometriosis on the psychological, sexual, and interpersonal functioning of both patients and their partners, in the journal Best Practice & Research Clinical Obstetrics and Gynecology.

Women with endometriosis experience a wide range of pelvic pain, which has four key consequences on patients: psychological, sexual, relationship, and social.

Women with endometriosis report heightened psychological distress, including higher levels of pain catastrophizing, stress and more depression and anxiety. Sexual function, pregnancy, infertility, and cultural differences have been shown to be related to psychological distress. Male partners also suffer from consequences of their partner's pain, showing increased rates of psychological distress.

Endometriosis appears to have an impact on all domains of sexual function - desire/arousal, orgasm, satisfaction, and pain-leading to sexual dysfunction and distress in 70-75% of patients. Cumulative prevalence of sexual dysfunction and distress are at 32% and 78%, respectively.

Endometriosis also has a detrimental impact on daily life and physical functioning. Between 16% and 61% of women experience difficulties with mobility, daily activities, and/or self-care. Furthermore, endometriosis has a negative effect on education and working life.

The development of innovative new interventions for endometriosis is needed to overcome the consequences of this condition on patients. However, research evaluating the efficacy of sex therapy, couple therapy, and pelvic floor physical therapy and studies taking a biopsychosocial and multidisciplinary approach in the treatment of endometriosis is lacking. There is an urgent need for teams comprising gynecologists, sexologists, psychologists/psychotherapists, and physiotherapists, with the involvement of patients and their partners, to work together in endometriosis management.  

Research Source: https://www.ncbi.nlm.nih.gov/pubmed/29545113