DEPRESSION IN ENDOMETRIOSIS: SHARED PATHOPHYSIOLOGICAL MECHANISMS AND CLINICAL IMPLICATIONS – A NARRATIVE REVIEW

Endometriosis is a chronic inflammatory disease associated with substantial physical and psychological morbidity. Depression is common among affected women, and its relationship with endometriosis appears to extend beyond the psychological consequences of chronic pain alone.

A structured narrative review of peer-reviewed literature was conducted using PubMed/MEDLINE, Scopus, and Google Scholar. Epidemiological, biological, psychosocial, and clinical evidence was synthesized qualitatively. Findings: Women with endometriosis report greater depressive symptom burden than healthy controls, although chronic pain contributes substantially to this association. Shared genetic susceptibility and inflammatory, neuroendocrine, hormonal, pain-processing, and tryptophan–kynurenine pathways may provide additional biological links, but direct evidence for several mechanisms remains limited. Chronic pelvic pain, infertility, fatigue, sleep disturbances, diagnostic difficulties, and stigma further contribute to psychological distress and impaired quality of life. Evidence for endometriosis-specific pharmacological treatment of depression is scarce, while preliminary studies suggest potential benefits from psychological interventions and multidisciplinary care.

The relationship between endometriosis and depression is multifactorial and best understood within a biopsychosocial framework. Further longitudinal and interventional studies are needed to clarify causal mechanisms and evaluate targeted approaches to treatment.

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