Presentation (CTI)

OBJECTIVES: Endometriosis is a chronic inflammatory gynaecologic disease characterized by endometrium tissue growing outside the uterine cavity. Recent studies highlighted that pelvic pain in endometriosis patients is associated with decline in mental health. This study aims to review published meta-analyses (MA) investigating the link between psychological quality of life and endometriosis, to quantify the impact on mental health.
METHODS: A targeted literature review was conducted on Pubmed and Google Scholar, on keywords associated with the pathology (“endometriosis”) and mental health (“Quality of life”, “Anxiety”, “Depression”, “Psychological”, “Mental health”, “depressive”, “HRQOL”). Publications were reviewed using PRISMA guidelines. Studies published in English during the last 10 years were included. No restriction on location was made. Studies investigating changes in outcomes based on surgery, therapy, treatment or alternative medicines were excluded for heterogeneity reasons.
RESULTS: Among 32 publications, only five relevant MA were identified. These analyses were conducted in several countries, including Europe, Asia, North America and Oceania. Most of the SLRs covered a significant period (1995-2020, 1998-2020). Studies focused on the association between endometriosis and mental health (depression, anxiety, quality of life, chronic pain and emotion regulation). The studies highlighted that women with endometriosis have higher rates of anxiety and depression and poorer quality of life than healthy women. However, the evidence is limited by heterogeneity, variability in diagnostic and psychological assessment methods, and potential publication bias. Furthermore, the specific contribution of endometriosis is difficult to disentangle from chronic pain effects, limiting causal interpretation.
CONCLUSIONS: Studies suggested that mental health interventions might improve well-being and pain-related outcomes. Research on psychological dimensions of endometriosis remains relatively recent, and knowledge gaps persist. In the context of the French National Strategy against Endometriosis, generating evidence is particularly relevant to better characterize the burden of the disease and to support the integration of mental health care into comprehensive management pathways.