Experiencing situations of severe stress or psychological distress can have a negative impact on the symptoms of endometriosis and, in general, on the psychophysical well-being of those who suffer from it. This is what a study published in Reproduction and fertilitywhich analyzed the symptoms of more than 4,000 patients during the first months of the pandemic, finding a general worsening in their physical and mental conditions.
What is Endometriosis
Endometriosis is a chronic and incurable disease affecting about 150 million women worldwide, 3 million of which in Italy. It is a very painful condition and mainly affects women of childbearing age between 25 and 35, it can compromise the ability to have children and its symptoms significantly worsen the quality of life. The cause is the presence of endometrial cells, which are normally found inside the uterus, in the other female genital organs and in the pelvic peritoneum.
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The first symptom of this disease is acute pelvic pain, but also the presence of heavy menstruation, tiredness, fatigue and sometimes fertility problems. In milder cases it is possible to keep pain and disease under control without proper treatment, perhaps with the help of diet: taking foods rich in fiber daily, for example, helps regulate the production of estrogen, and omega 3 instead they help fight inflammatory processes.
There are also hormonal therapies when the symptoms begin to increase and, finally, in the most serious cases surgery is resorted to. In Italy, there are about 20,000 surgical procedures carried out by the NHS each year.
Chronic diseases and psychological malaise
To the physical symptoms, precisely because of the persistent pain and stress caused by one’s condition, there are also problems of a psychological nature. Endometriosis is in fact a disease that can compromise the quality of life and prevent its regular development. Suffice it to say that in Italy about 33 million working days are lost every year due to this disease.
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Several studies have shown, for this and other chronic diseases, that stress can exacerbate pain perception and cause psychological damage. And, among the conditions of prolonged stress to which we have been subjected in recent years, the pandemic certainly plays an important role.
The study investigated, for the first time, precisely the link between the psychological difficulties and stress of the first months of the pandemic and the worsening of the physical symptoms of endometriosis, and also of psychological malaise.
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The worsening of symptoms with the global pandemic
The analysis involved 4,717 women with endometriosis, who were asked to fill out an online self-assessment questionnaire that compared the physical symptoms and psychological conditions at the beginning of the pandemic, between May and June 2020, with those of six months earlier.
The questions were about change in endometriosis symptoms (pelvic pain, tiredness / fatigue, level of bleeding), mental health related symptoms like depression and anxiety, catastrophizing of pain (a measure of how you think about your pain) , and the impact of the pandemic on personal life.
The results showed that pelvic pain, fatigue and bleeding worsened for more than 39 percent of the participants. Worsening pain and increased fatigue were significantly correlated with worsening mental health. Finally, people who already had a previous diagnosis of poor mental health (38.8%) were the most likely to report worsening symptoms.
The last result, in particular, demonstrates the importance of the mental dimension in people suffering from chronic diseases. Women who suffer from endometriosis in particular – and people who have an incurable chronic disease more generally – are more sensitive and more predisposed, than others, to suffer psychological consequences and to somatize the conditions of prolonged stress on a physical level.
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The stressful experience of the pandemic has had a significant impact on physical and mental health since the early months. The next step will be to assess whether, even in the long term, Covid-19 has left an aftermath on women with endometriosis. However, it is important to consider, as the researchers underline in the study, that setting up psychological support interventions could be fundamental to help these patients not only in the context of a global emergency condition such as that experienced during the pandemic, but to better cope. the disease every day.