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

Aylin Candan, Candan A, Alexandra Kohl Schwartz, Birchler K, Kurt Birchler, Brigitte Leeners
Journal of Psychosomatic Research · 2025 · vol. 196 , pp. 112346 · doi:10.1016/j.jpsychores.2025.112346 · PMID:40815907 · W4413215141
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

A multi-center study found psychosomatic diseases and symptoms, but not physiological ones, were significantly associated with endometriosis diagnosis and exacerbated pain frequency.

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Abstract

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.

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Condition tags

endometriosischronic_pelvic_paininfertility

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis

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.

References (51)

Cited by (2)

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