How Close Relationships Moderate Symptom Related Improvement in Endometriosis

Introduction: Endometriosis is a chronic, incurable condition that has negative impacts on several domains, including mood, stress, fatigue, sleep and pain, particularly during menstruation. Endometriosis can also affect relationships; the impact of relationship satisfaction has rarely been studied quantitatively. This thesis examined the within-person impact of menstrual symptoms on daily functioning in women with endometriosis and tested whether relationship satisfaction moderated these effects Methods: A multiple n-of-1 design was used. Seven participants diagnosed with endometriosis completed daily self-reports of pain, mood, stress, sleep, and activity over two weeks (one menstrual and one non-menstrual). Objective activity was tracked using a smartwatch. Results: Descriptive and visual analyses revealed individual variability in symptom patterns. Some participants reported increased pain and reduced sleep quality during menstruation, others showed minimal or opposite changes. Group-level analyses found no statistically significant differences in mood, stress, sleep, or activity between menstrual and non-menstrual weeks. Relationship satisfaction did not significantly interact with pain or any outcome. Conclusions: The heterogeneity of women’s experience of endometriosis is highlighted. Strengths and limitations of the present study are also discussed and recommendations for future research include longer data collection periods, larger samples and engagement with advocacy groups is encouraged.