Endometriosis is when uterine lining cells grow outside the uterus. They often grow into other areas in the pelvis or stomach. It is not fully known how this tissue migrates to these areas. According to the American College of Obstetricians and Gynecologists, at least 1 in 10 women of reproductive age have this health issue.
Many people with endometriosis have severe pain. This pain can impact every area of life. This includes mental health.
Scientists know there is a strong link between endometriosis and depression.
There are ways to treat endometriosis. The first step is to get a diagnosis. At UPMC, we diagnose and treat your endometriosis — and the mental toll it takes.
Before diving into it, a quick note about language and gender. Endometriosis can affect anyone with a uterus, regardless of their gender. This article uses “women” or “female” to refer to the sex assigned at birth.
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What Are the Symptoms of Endometriosis?
When uterine lining cells grow where they’re not supposed to, they can cause many problems. Endometriosis tissue can grow in the ovaries and fallopian tubes. It can also grow on the bladder, rectum, and intestines.
As the tissue spreads and grows, it irritates these areas. And it can bleed like the uterine lining during the menstrual cycle. This is why people with endometriosis can have such heavy bleeding, bladder pain, gastrointestinal distress and pain, and painful intercourse.
The bleeding can also make scar tissue form. This scar tissue can stick the organs together. This causes pain and other physical symptoms.
It makes sense, then, that chronic pelvic pain is one of the most common symptoms of endometriosis. Doctors define chronic pelvic pain as pain in the pelvic area that’s constant or recurs over six months.
People with endometriosis may also have:
- Painful periods, often with extreme tiredness.
- Pain during or after sex.
- Painful poop.
- Painful pee.
- Infertility.
What Is the Connection Between Endometriosis and Depression?
A 2017 review paper examined 15 studies totaling more than 11,000 women with endometriosis. The review found a link between endometriosis and depression. Often, this link is thought to be due to endometriosis symptoms affecting a person’s quality of life, but there is also a though that chronic inflammation from a condition like endometriosis can increase symptoms of depression.
For example, it’s hard to be intimate with a partner if sex is painful. It’s exhausting to dread pain with each period. Chronic pain makes maintaining a regular work schedule and holding down a job difficult.
People with endometriosis may feel guilty for missing work or social events. They may feel resentful and angry that pain seems to be ruling their life. This can lead to feelings of hopelessness.
Rather than a straight cause and effect with endometriosis and mental health, it’s a cycle. Chronic pain leads to depression and anxiety. These mental health issues increase pain, which feeds into anxiety and depression.
Being second-guessed can make feelings of depression and anxiety worse. People with endometriosis say their doctors, colleagues, and loved ones often think they are exaggerating the pain.
Mental health symptoms can worsen when people don’t take their pain seriously. Plus, endometriosis symptoms can be embarrassing to explain.
For these and other reasons, endometriosis often goes undiagnosed for years. The longer someone lives with this health issue, the more likely it is to affect their mental health.
Getting Treatment for Endometriosis
UPMC Magee-Womens Center for Endometriosis and Chronic Pelvic Pain specializes in treating endometriosis.
Our doctors understand the symptoms of endometriosis and how debilitating they can be. We know this painful lifelong issue affects physical and mental health. This is why we treat the whole person.
Doctors first begin the process of diagnosing endometriosis with a history and pelvic exam. Pelvic exams are always optional in patients with pain. We may then do a surgical procedure to confirm a diagnosis and its severity, as well as remove the endometriosis. After the surgery (laparoscopy), the endometrial tissue will also be tested in a lab.
Our specialist surgeons at Magee have advanced training to remove as much of the endometriosis as possible, which is the gold standard of treatment.
Tissue removal during laparoscopy can also improve symptoms of mild endometriosis. Medicines like hormone therapy may also help with symptoms by slowing the growth of the tissue.
It’s vital to talk to your doctor about your fertility plans. Surgery can help maintain or even improve fertility.
Treating Depression Associated with Endometriosis
For some people, treatment and symptom relief will greatly improve mental health. But you may need more support.
Some providers offer behavioral therapy for people with endometriosis and chronic pelvic pain. These issues can bring up mental health issues that may not go away when symptoms improve.
In addition to talk therapy, medicine to treat depression may be helpful.
If you think you have endometriosis, seek treatment sooner rather than later. It’s not in your head. It’s a disease you did nothing to cause and is treatable.