Endometriosis and mental health

Endometriosis can affect mental health. Chronic pain, being unable to make plans, worries about pregnancy and years of not being taken seriously are emotionally exhausting. The ESHRE guideline openly recognises the impact of the disease on quality of life, work and school, sex, relationships and emotional wellbeing, and recommends considering psychological support. Feeling that you are struggling is not a weakness; it is an understandable response.

What can be hard?

• The unpredictability of pain and how it disrupts plans.
• Symptoms being brushed off as “normal” and the feeling of not being believed.
• Uncertainty about pregnancy and the future.
• Difficulties in relationships and sex life.
• Fatigue.

What do the guidelines say?

• ESHRE recommends considering follow-up and psychological support for people with a confirmed diagnosis, particularly deep and ovarian endometriosis.
• ESHRE also recommends that clinicians discuss non-medical strategies for quality of life and emotional wellbeing. At the same time it says it cannot recommend any particular method (psychological interventions, exercise, acupuncture and others) for reducing pain, because the benefits and harms are unclear.
• The World Endometriosis Society consensus notes that many people report “talking to someone”, cognitive behavioural therapy and exercise as helpful, but that these have not been tested in well-designed studies.

What might help?

Evidence is limited, but practical steps do no harm and help many people:

• Telling your doctor about your emotional state as well.
• Asking a mental health professional for support.
• Meeting others with the same experience in support groups.
• Giving yourself realistic goals and room to rest.

If you have thoughts of harming yourself, call 112 in Türkiye or go to your nearest emergency department without waiting.

For general treatment options see the treatment page, and to prepare for an appointment see the preparation guide.