The endometriosis pain course: a randomized controlled trial of an internet-delivered psychological pain management program for endometriosis

Shianika S Chandra, Madelyne A. Bisby, Amelia J. Scott, Nickolai Titov, Blake F. Dear
Pain · 2025 · vol. 167(1) , pp. 80–93 · doi:10.1097/j.pain.0000000000003784 · PMID:40844480 · W4413428765
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-07 ⓘ

An 8-week internet-delivered psychological pain management program significantly improved pain-related disability, depression, and anxiety in women with endometriosis compared to a waitlist control.

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⚙ AI-generated deep summary by qwen3.7-flash, 2026-08-17 · read from full text ⓘ

This randomized controlled trial evaluated the efficacy of an eight-week, internet-delivered cognitive-behavioral therapy program for women suffering from endometriosis-related pelvic pain. The study assigned 193 participants to either the treatment group or a waitlist control and measured outcomes regarding pain disability, depression, anxiety, and pain intensity. Results indicated that the intervention led to significant improvements in pain-related disability, depression, and anxiety compared to the control group, with benefits sustained at three-month follow-up, although no significant difference was found in average pain intensity. The authors note that while the program was acceptable with high completion rates, further research is needed to assess long-term outcomes and predictors of response. This paper is centrally about endometriosis — specifically focusing on psychological management strategies for chronic pelvic pain associated with the condition.

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Abstract

Limited research has examined psychological treatments for endometriosis-related chronic pain, despite its association with elevated disability, depression, and anxiety. Remotely delivered treatments have the potential to overcome barriers to access face-to-face psychological care, however, no studies have examined this format in endometriosis patients. The current study examined the efficacy and acceptability of an internet-delivered, psychological, pain management program for women with endometriosis-related pain. In this two-arm trial, 193 participants experiencing endometriosis-related pelvic pain were randomly assigned to the 8-week treatment or a waitlist control. The treatment was an adapted version of an established internet-delivered pain management program based on cognitive-behavior therapy principles. Relative to control, the treatment group reported significantly greater improvements (between groups Cohen's d ; average percentage change) in the primary outcomes of pain-related disability ( d = 0.35; 24%), depression ( d = 0.40; 17%), and anxiety ( d = 0.26; 17%) from pre- to post-treatment. Improvements were sustained at 3-month follow-up. No between-group difference was observed on the secondary outcome of average pain intensity ( d = 0.28; 17%, P = 0.054). High lesson completion and treatment satisfaction rates were observed. Mean clinician time per participant was 70 minutes (SD = 68). The current findings indicate the potential of a pain-focused psychological approach in supporting endometriosis-related pain, and the potential of the internet-delivered format in increasing access to care. Future research is needed to examine long-term outcomes and investigate factors associated with optimal treatment response.
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Limited research has examined psychological treatments for endometriosis-related chronic pain, despite its association with elevated disability, depression, and anxiety. Remotely delivered treatments have the potential to overcome barriers to access face-to-face psychological care, however, no studies have examined this format in endometriosis patients. The current study examined the efficacy and acceptability of an internet-delivered, psychological, pain management program for women with endometriosis-related pain. In this two-arm trial, 193 participants experiencing endometriosis-related pelvic pain were randomly assigned to the 8-week treatment or a waitlist control. The treatment was an adapted version of an established internet-delivered pain management program based on cognitive-behavior therapy principles. Relative to control, the treatment group reported significantly greater improvements (between groups Cohen's d; average percentage change) in the primary outcomes of pain-related disability (d = 0.35; 24%), depression (d = 0.40; 17%), and anxiety (d = 0.26; 17%) from pre- to post-treatment. Improvements were sustained at 3-month follow-up. No between-group difference was observed on the secondary outcome of average pain intensity (d = 0.28; 17%, P = 0.054). High lesson completion and treatment satisfaction rates were observed. Mean clinician time per participant was 70 minutes (SD = 68). The current findings indicate the potential of a pain-focused psychological approach in supporting endometriosis-related pain, and the potential of the internet-delivered format in increasing access to care. Future research is needed to examine long-term outcomes and investigate factors associated with optimal treatment response. The endometriosis pain course: a randomized controlled trial of an internet-delivered psychological pain management program for endometriosis - Buy - SDC An internet-delivered pain management program improved disability, depression, and anxiety outcomes in endometriosis patients. The program was acceptable, with high treatment completion and satisfaction rates.

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Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Cognitive Behavioral Therapy Cognitive Behavioral Therapy Cognitive Behavioral Therapy Cognitive Behavioral Therapy Cognitive Behavioral Therapy Cognitive Behavioral Therapy Cognitive Behavioral Therapy Cognitive Behavioral Therapy Cognitive Behavioral Therapy Cognitive Behavioral Therapy Cognitive Behavioral Therapy Cognitive Behavioral Therapy Cognitive Behavioral Therapy Cognitive Behavioral Therapy Cognitive Behavioral Therapy Cognitive Behavioral Therapy Cognitive Behavioral Therapy Cognitive Behavioral Therapy Cognitive Behavioral Therapy Cognitive Behavioral Therapy

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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