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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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 (2-hop)

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. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (51)

Cited by (2)

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