About
The Journal "Obstetrics and Gynecology"Journal HistoryAims and ScopePolicies on Conflict of Interest, Human and Animal Rights, and Informed ConsentEditorial ProcessData sharing statementAdvertising PolicyThe Process for Handling Cases Requiring Corrections, Retractions, and Editorial Expressions of ConcernEditorial BoardEditorial CounsilInformation for ProfessionalsNewsContacts
ArchiveEthical StandardsSubscription
For authors
InstructionsInformed consent policyContract offerEASE GuidelinesICJME CriteriaWAME Recommendations on ChatGPT and Chatbots in Relation to Scholarly Publications
Reviewing
About
The Journal "Obstetrics and Gynecology"Journal HistoryAims and ScopePolicies on Conflict of Interest, Human and Animal Rights, and Informed ConsentEditorial ProcessData sharing statementAdvertising PolicyThe Process for Handling Cases Requiring Corrections, Retractions, and Editorial Expressions of ConcernEditorial BoardEditorial CounsilInformation for ProfessionalsNewsContacts
ArchiveEthical StandardsSubscription
For authors
InstructionsInformed consent policyContract offerEASE GuidelinesICJME CriteriaWAME Recommendations on ChatGPT and Chatbots in Relation to Scholarly Publications
Reviewing
Logout
Obstetrics and Gynegology2024№7
Modern approaches to complex patient-focused...

Modern approaches to complex patient-focused therapy of endometriosis as a psychosomatic pathology of social significance

DOI
https://dx.doi.org/10.18565/aig.2024.79

Managadze I.D., Nesterova A.A., Levakov S.A.

I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia, Moscow, Russia

Endometriosis is a chronic inflammatory disease characterized by the presence of endometrium-like tissue outside the uterus. One in nine women are diagnosed with endometriosis and most of them experience dysmenorrhea, non-menstrual pelvic pain, asthenia and infertility. Endometriosis should be considered as a systemic, not only gynecologic disease, therefore it is important to study the psychosocial mechanisms of its development. Endometriosis can be associated with significant psychosomatic and social discomfort, and more research is needed to understand the relationship between the various factors that influence its development.
The aim of this review  is to identify possible approaches to multimodal patient-focused therapy of endometriosis aimed at overcoming psychological and emotional predictors of the development of this socially significant pathology and improving the quality of life of women with endometriosis.
Conclusion: Endometriosis is a complex gynecologic disease and psychological factors such as emotional distress and cognitive processes play an important role in its development. Multiple studies are currently conducted to reveal the complex of psychosomatic factors that affect women suffering from endometriosis and to determine the key links in the pathogenesis of these processes. Thus, it will be possible to study the psychological symptoms comprehensively and identify potential approaches to prevention and treatment aimed at eliminating these predictors and improving the quality of life of patients with endometriosis. 

Authors’ contributions: Levakov S.A. – developing the concept and design of the study, editing the text; Managadze I.D., Nesterova A.A. – collection and analysis of the literary data, writing the text. 
Conflicts of interest: The authors declare no possible conflicts of interest.
Funding: The study was conducted without sponsorship.
For citation: Managadze I.D., Nesterova A.A., Levakov S.A. Modern approaches to complex patient-focused therapy of endometriosis as a psychosomatic pathology of social significance.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2024; (7): 28-39 (in Russian)
https://dx.doi.org/10.18565/aig.2024.79

Keywords

endometriosis
chronic pelvic pain
affective disorders
anxiety
depression
psychoemotional status
endometriosis treatment
endometriosis diagnosis
psychological aspects of endometriosis
digital immersive technologies
cognitive behavioral therapy
psychological approaches
Full text (in Russian)

References

  1. Dowding C., Mikocka-Walus A., Skvarc D., Van Niekerk L., O'Shea M., Olive L. et al. The temporal effect of emotional distress on psychological and physical functioning in endometriosis: a 12 month prospective study. Appl. Psychol. Health Well Being. 2023; 15(3): 901-18. https://dx.doi.org/10.1111/aphw.12415.
  2. van Stein K., Schubert K., Ditzen B., Weise C. Understanding psychological symptoms of endometriosis from a research domain criteria perspective. J. Clin. Med. 2023; 12(12): 4056. https://dx.doi.org/10.3390/jcm12124056.
  3. Chaman-Ara K., Bahrami M.A., Bahrami E. Endometriosis psychological aspects: a literature review. J. Endometr. Pelvic Pain Disord. 2017; 9(2): 105-11. https://dx.doi.org/10.5301/jeppd.5000276.
  4. Wang Y., Li B., Zhou Y., Wang Y., Han X., Zhang S. et al. Does endometriosis disturb mental health and quality of life? A systematic review and meta-analysis. Gynecol. Obstet. Invest. 2021; 86(4): 315-35. https://dx.doi.org/10.1159/000516517.
  5. Fiala L., Lenz J., Adamik Z., Sajdlova R., Kestlerova D., Vetvicka V. Psychological hallmarks of endometriosis with emphasis on sexual dysfunction, stress, anxiety and depressive symptoms. Int. Clin. Pathol. J. 2023; 10(1): 45-8. https://dx.doi.org/10.15406/icpjl.2023.10.00218.
  6. Sherman K.A., Pehlivan M.J., Singleton A., Hawkey A., Redfern J., Armour M. et al. Co-design and development of EndoSMS, a supportive text message intervention for individuals living with endometriosis: mixed methods study. JMIR Form. Res. 2022; 6(12): e40837. https://dx.doi.org/10.2196/40837.
  7. Thiel P., Burke M.J., Bridge-Cook P., Leonardi M. Nocebo effects in the treatment of endometriosis. Reprod. Fertil. 2021; 2(4): C35-C38. https://dx.doi.org/10.1530/RAF-21-0040.
  8. Roomaney R., Kagee A. Salient aspects of quality of life among women diagnosed with endometriosis: a qualitative study. J. Health Psychol. 2018; 23(7): 905-16. https://dx.doi.org/10.1177/1359105316643069.
  9. Donatti L., Ramos D.G., Andres M.P., Passman L.J., Podgaec S. Patients with endometriosis using positive coping strategies have less depression, stress and pelvic pain. Einstein (Sao Paulo). 2017; 15(1): 65-70. https://dx.doi.org/10.1590/S1679-45082017AO3911.
  10. Meissner K., Schweizer-Arau A., Limmer A., Preibisch C., Popovici R.M., Lange I. et al. Psychotherapy with somatosensory stimulation for endometriosis-associated pain: a randomized controlled trial. Obstet. Gynecol. 2016; 128(5): 1134-42. https://dx.doi.org/10.1097/AOG.0000000000001691.
  11. Evans S., Fernandez S., Olive L., Payne L.A., Mikocka-Walus A. Psychological and mind-body interventions for endometriosis: a systematic review. J. Psychosom. Res. 2019; 124: 109756. https://dx.doi.org/10.1016/j.jpsychores.2019.109756.
  12. Ledermann K., von Känel R., Wagner J. A psychosomatic perspective on endometriosis - a mini review. Cortica. 2023; 2(1): 197-214. https://dx.doi.org/10.26034/cortica.2023.3778.
  13. Van Niekerk L., Weaver-Pirie B., Matthewson M. Psychological interventions for endometriosis-related symptoms: a systematic review with narrative data synthesis. Arch. Womens Ment. Health. 2019; 22(6): 723-35. https://dx.doi.org/10.1007/s00737-019-00972-6.
  14. The Royal Australian and New Zealand College of Obsetetricians and Gynaecologists (RANZCOG). Endometriosis. Clinical Practice Guideline. Australian clinical practice guideline for the diagnosis and management of endometriosis. Ranzog; 2021. 70p. Available at: https://ranzcog.edu.au/wp-content/uploads/2022/02/Endometriosis-clinical-practice-guideline.pdf
  15. Bérubé M., Martorella G., Côté C., Gélinas C., Feeley N., Choinière M. et al. The effect of psychological interventions on the prevention of chronic pain in adults: a systematic review and meta-analysis. Clin. J. Pain. 2021; 37(5): 379-95. https://dx.doi.org/10.1097/AJP.0000000000000922.
  16. Mechsner S. Ganzheitliche Behandlung der Endometriose [Holistic treatment of endometriosis]. Schmerz. 2023; 37(6): 437-447. (in German). https://dx.doi.org/10.1007/s00482-023-00747-0.
  17. Schwartz A.S.K., Gross E., Geraedts K., Rauchfuss M., Wölfler M.M., Häberlin F. et al. The use of home remedies and complementary health approaches in endometriosis. Reprod. Biomed. Online. 2019; 38(2): 260-71. https://dx.doi.org/10.1016/j.rbmo.2018.10.009.
  18. Facchin F., Barbara G., Dridi D., Alberico D., Buggio L., Somigliana E. et al. Mental health in women with endometriosis: searching for predictors of psychological distress. Hum. Reprod. 2017; 32(9): 1855-61. https://dx.doi.org/10.1093/humrep/dex249.
  19. Buggio L., Barbara G., Facchin F., Frattaruolo M.P., Aimi G., Berlanda N. Self-management and psychological-sexological interventions in patients with endometriosis: strategies, outcomes, and integration into clinical care. Int. J. Womens Health. 2017; 9: 281-93. https://dx.doi.org/10.2147/IJWH.S119724.
  20. McKnight K., Omotosho O., Jassim S., Cotter A. Exercise and endometriosis - is there a promising future? A narrative review. Ir. J. Med. Sci. 2024. https://dx.doi.org/10.1007/s11845-024-03733-2.
  21. Leonardi M., Gibbons T., Armour M., Wang R., Glanville E., Hodgson R. et al. When to do surgery and when not to do surgery for endometriosis: a systematic review and meta-analysis. J. Minim. Invasive Gynecol. 2020; 27(2): 390-407.e3. https://dx.doi.org/10.1016/j.jmig.2019.10.014.
  22. Hansen K.E., Brandsborg B., Kesmodel U.S., Forman A., Kold M., Pristed R. et al. Psychological interventions improve quality of life despite persistent pain in endometriosis: results of a 3-armed randomized controlled trial. Qual. Life Res. 2023; 32(6): 1727-44. https://dx.doi.org/10.1007/s11136-023-03346-9.
  23. Geneen L.J., Moore R.A, Clarke C., Martin D., Colvin L.A., Smith B.H. Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews. Cochrane Database Syst. Rev. 2017; 1(1): CD011279. https://dx.doi.org/10.1002/14651858.
  24. Sims O.T., Gupta J., Missmer S.A., Aninye I.O. Stigma and endometriosis: a brief overview and recommendations to improve psychosocial well-being and diagnostic delay. Int. J. Environ. Res. Public Health. 2021; 18(15): 8210. https://dx.doi.org/10.3390/ijerph18158210.
  25. Loughnan S.A., Joubert A.E., Grierson A., Andrews G., Newby J.M. Internet-delivered psychological interventions for clinical anxiety and depression in perinatal women: a systematic review and meta-analysis. Arch. Womens Ment. Health. 2019; 22(6): 737-50. https://dx.doi.org/10.1007/s00737-019-00961-9.
  26. Andersson G., Cuijpers P., Carlbring P., Riper H., Hedman E. Guided internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: a systematic review and meta-analysis. World Psychiatry. 2014; 13(3): 288-95. https://dx.doi.org/10.1002/wps.20151.
  27. Carlbring P., Andersson G., Cuijpers P., Riper H., Hedman-Lagerlöf E. Internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: an updated systematic review and meta-analysis. Cogn. Behav. Ther. 2018; 47(1): 1-18. https://dx.doi.org/10.1080/16506073.2017.1401115.
  28. Schubert K., Lohse J., Kalder M., Ziller V., Weise C. Internet-based cognitive behavioral therapy for improving health-related quality of life in patients with endometriosis: study protocol for a randomized controlled trial. Trials. 2022; 23(1): 300. https://dx.doi.org/10.1186/s13063-022-06204-0.
  29. Facchin F., Barbara G., Saita E., Mosconi P., Roberto A., Fedele L. et al. Impact of endometriosis on quality of life and mental health: pelvic pain makes the difference. J. Psychosom. Obstet. Gynaecol. 2015; 36(4): 135-41. https://dx.doi.org/10.3109/0167482X.2015.1074173.
  30. Cunningham J.A., Kypri K., McCambridge J. Exploratory randomized controlled trial evaluating the impact of a waiting list control design. BMC Med. Res. Methodol. 2013; 13: 150. https://dx.doi.org/10.1186/1471-2288-13-150.
  31. Nieves-Vázquez C.I., Detrés-Marquéz A.C., Torres-Reverón A., Appleyard C.B., Llorens-De Jesús A.P., Resto I.N. et al. Feasibility and acceptability of an adapted environmental enrichment intervention for endometriosis: a pilot study. Front. Glob. Womens Health. 2023; 3: 1058559. https://dx.doi.org/10.3389/fgwh.2022.1058559.
  32. De Hoyos G., Ramos-Sostre D., Torres-Reverón A., Barros-Cartagena B., López-Rodríguez V., Nieves-Vázquez C. et al. Efficacy of an environmental enrichment intervention for endometriosis: a pilot study. Front. Psychol. 2023; 14: 1225790. https://dx.doi.org/10.3389/fpsyg.2023.1225790.
  33. Yin B., Jiang H., Liu X., Guo S.W. Enriched environment decelerates the development of endometriosis in mouse. Reprod. Sci. 2020; 27(7): 1423-35. https://dx.doi.org/10.1007/s43032-019-00117-1.
  34. Brasil D.L., Montagna E., Trevisan C.M., La Rosa V.L., Lagana A.S., Barbosa C.P. et al. Psychological stress levels in women with endometriosis: systematic review and meta-analysis of observational studies. Minerva Med. 2020; 111(1): 90-102. https://dx.doi.org/10.23736/S0026-4806.19.06350-X.
  35. Rathbone A.L., Prescott J. The use of mobile apps and SMS messaging as physical and mental health interventions: systematic review. J. Med. Internet Res. 2017; 19(8): e295. https://dx.doi.org/10.2196/jmir.7740.
  36. van Barneveld E., Manders J., van Osch F.H.M., van Poll M., Visser L., van Hanegem N. et al. Depression, anxiety, and correlating factors in endometriosis: a systematic review and meta-analysis. J. Womens Health (Larchmt). 2022; 31(2): 219-30. https://dx.doi.org/10.1089/jwh.2021.0021.
  37. Gambadauro P., Carli V., Hadlaczky G. Depressive symptoms among women with endometriosis: a systematic review and meta-analysis. Am. J. Obstet. Gynecol. 2019; 220(3): 230-41. https://dx.doi.org/10.1016/j.ajog.2018.11.123.
  38. Buggio L., Barbara G., Facchin F., Frattaruolo M.P., Aimi G., Berlanda N. Self-management and psychological-sexological interventions in patients with endometriosis: strategies, outcomes, and integration into clinical care. Int. J. Womens Health. 2017; 9: 281-93. https://dx.doi.org/10.2147/IJWH.S119724.
  39. Brooks T., Sharp R., Evans S., Baranoff J., Esterman A. Predictors of psychological outcomes and the effectiveness and experience of psychological interventions for adult women with chronic pelvic pain: a scoping review. J. Pain Res. 2020; 13: 1081-102. https://dx.doi.org/10.2147/JPR.S245723.
  40. Sherman K.A., Pehlivan M.J., Redfern J., Armour M., Dear B., Singleton A. et al. A supportive text message intervention for individuals living with endometriosis (EndoSMS): randomized controlled pilot and feasibility trial. Contemp. Clin. Trials Commun. 2023; 32: 101093. https://dx.doi.org/10.1016/j.conctc.2023.101093.
  41. Agyapong V.I.O., Hrabok M., Vuong W., Shalaby R., Noble J.M., Gusnowski A. et al. Changes in stress, anxiety, and depression levels of subscribers to a daily supportive text message program (Text4Hope) during the COVID-19 pandemic: cross-sectional survey study. JMIR Ment. Health. 2020; 7(12): e22423. https://dx.doi.org/10.2196/22423.
  42. Noble J.M., Vuong W., Surood S., Urichuk L., Greenshaw A.J., Agyapong V.I.O. Text4Support Mobile-Based Programming for individuals accessing addictions and mental health services-retroactive program analysis at baseline, 12 weeks, and 6 months. Front. Psychiatry. 2021; 12: 640795. https://dx.doi.org/10.3389/fpsyt.2021.640795.
  43. Moreira M.F., Gamboa O.L., Pinho Oliveira M.A. Cognitive-affective changes mediate the mindfulness-based intervention effect on endometriosis-related pain and mental health: a path analysis approach. Eur. J. Pain. 2023; 27(10):1187-202. https://dx.doi.org/10.1002/ejp.2149.
  44. Hofmann S.G., Hayes S.C. The future of intervention science: process-based therapy. Clin. Psychol. Sci. 2019; 7(1): 37-50. https://dx.doi.org/10.1177/2167702618772296.
  45. Allaire C., Williams C., Bodmer-Roy S., Zhu S., Arion K., Ambacher K. et al. Chronic pelvic pain in an interdisciplinary setting: 1-year prospective cohort. Am. J. Obstet. Gynecol. 2018; 218(1): 114.e1-114.e12. https://dx.doi.org/10.1016/j.ajog.2017.10.002.
  46. Grundström H., Larsson B., Arendt-Nielsen L., Gerdle B., Kjølhede P. Pain catastrophizing is associated with pain thresholds for heat, cold and pressure in women with chronic pelvic pain. Scand. J. Pain. 2020; 20(3): 635-46. https://dx.doi.org/10.1515/sjpain-2020-0015.
  47. Moreira M.F., Gamboa O.L., Pinho Oliveira M.A. A single-blind, randomized, pilot study of a brief mindfulness-based intervention for the endometriosis-related pain management. Eur. J. Pain. 2022; 26(5): 1147-62. https://dx.doi.org/10.1002/ejp.1939.
  48. Pokrzywinski R.M., Soliman A.M., Chen J., Snabes M.C., Coyne K.S., Surrey E.S. et al. Achieving clinically meaningful response in endometriosis pain symptoms is associated with improvements in health-related quality of life and work productivity: analysis of 2 phase III clinical trials. Am. J. Obstet. Gynecol. 2020; 222(6): 592.e1-592.e10. https://dx.doi.org/10.1016/j.ajog.2019.11.1255.
  49. Merlot B., Elie V., Périgord A., Husson Z., Jubert A., Chanavaz-Lacheray I. et al. Pain reduction with an immersive digital therapeutic in women living with endometriosis-related pelvic pain: at-home self-administered randomized controlled trial. J. Med. Internet Res. 2023; 25: e47869. https://dx.doi.org/10.2196/47869.
  50. Merlot B., Dispersyn G., Husson Z., Chanavaz-Lacheray I., Dennis T., Greco-Vuilloud J. et al. Pain reduction with an immersive digital therapeutic tool in women living with endometriosis-related pelvic pain: randomized controlled trial. J. Med. Internet Res. 2022; 24(9): e39531. https://dx.doi.org/10.2196/39531.

Received 03.04.2024

Accepted 19.06.2024

About the Authors

Ioanna J. Managadze, student, N.V. Sklifosovsky ICM, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University),
119991, Russia, Moscow, Trubetskaya str., 8, bld. 2, +7(495)609-14-00, ktb1966@mail.ru, https://orcid.org/0000-0001-8745-9372
Angelina A. Nesterova, PhD student of the Department of Obstetrics and Gynecology, N.V. Sklifosovsky ICM, I.M. Sechenov First Moscow State Medical University,
Ministry of Health of Russia (Sechenov University), 119991, Russia, Moscow, Trubetskaya str., 8, bld. 2, +7(495)609-14-00, angelina.aleksashina@mail.ru,
https://orcid.org/0009-0004-1913-5703
Sergey A. Levakov, Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology, N.V. Sklifosovsky ICM, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), 119991, Russia, Moscow, Trubetskaya str., 8, bld. 2, +7(495)609-14-00, levakoff@yandex.ru,
https://orcid.org/0000-0002-4591-838X
Corresponding author: Sergey A. Levakov, levakoff@yandex.ru

Similar Articles

№7 / 2024
Ponomareva T.A., Altukhova O.B., Ponomarenko I.V., Churnosov M.I.
Novel concepts in the pathogenesis and risk factors of endometriosis
№6 / 2024
Chernukha G.E., Solopova A. E., Pronina V.A.
New possibilities for assessing the magnetic resonance characteristics of endometrioid ovarian cysts and their response to dienogest therapy
№9 / 2024
Bezhenar V.F., Kuzmina N.S., Kruglov S.Yu., Gramatikova A.G., Izorkina V.A., Medvedeva I.V., Demidov A.D., Strukova D.S., Fedosova D.V., Barnash I.A.
Differentiated approaches to the development of prolonged treatment regimens for patients with endometriosis in the postoperative period
№10 / 2024
Keshchyan L.V., Lyalichkina N.A., Shuginin I.O.
Psychological aspects of obstetric and perinatal pathology
№5 / 2023
Chernukha G.E., Pronina V.A.
Prolonged hormonal therapy for endometriosis: how to make the right choice?
By continuing to use our site, you consent to the processing of cookies that ensure the proper functioning of the site.