Solving the fertility problem in women with endometriosis is still a difficult challenge for infertility…
The woman with endometriosis is a woman with an often troubled baggage, characterized in many cases by a pain not understood and not validated, often pointed out as “unable to tolerate a classic menstrual pain”. It is evident that arriving at a diagnosis also means being able to give a name and an answer to an often disabling pain.
It is of fundamental importance to combine medical treatment with psychological support for a better adaptation to the disease state and a lower impairment of the quality of life. The psychological path must aim at reducing the anxiety and anguish underlying the disease and the stress associated with feelings of inadequacy, incompleteness and loss of one’s reproductive role that infertility can entail.
The impact with this disease generates new living and living conditions for the patient, even the impact with her diagnosis drastically and negatively alters future prospects.
The predominant feeling in the impact with the disease in general, and specifically with endometriosis, is fear, which takes various forms: fears about physical pathology (symptoms, pains), fears about treatments and after-effects (fear of surgery, fear of physical changes and altered body image, fears of relapse), fears concerning the psychological effects and personal and existential fears.
Other very common reactions are anger and guilt.
It is possible to identify some phases relating to the psychological process that affects the patient from the onset of symptoms, to the definition of the diagnosis and diagnostic choices. Initially there is a first phase of recognition of physical symptoms, which force the person to carry out various clinical examinations. These moments are lived with awe and fear of what they might reveal.
Subsequently, the diagnostic phase takes place, which can lead to some initial relief since the cause of the symptoms is discovered, at the same time, however, there is the need for it to be assimilated, to become aware of the disease.
The formulation of the diagnosis recalls fears and important emotional experiences, which are strengthened in the treatment phase. A woman may be faced with the choice of overcoming the disease or fulfilling basic needs such as becoming a mother or feeling fully a woman.
The presence of pelvic pain is an important factor to consider when discussing the correlation between endometriosis and psychological diseases.
The pain appears to be independent of the stage of endometriosis, so women with mild endometriosis may suffer from more intense pelvic pain than those with a more severe endometriosis condition.
Pelvic pain has been shown to have negative effects on mental health and quality of life: women suffering from this symptom in particular report high levels of anxiety and depression, limitation in social activities, loss of working capacity, reduced quality of life.
Some scholars have shown that endometriosis is related to a wide range of psychiatric symptoms such as anxiety, depression, in particular, but also stress and poor quality of life.
By studying 81 women (40 with endometriosis and 41 with gynecological problems) with pelvic pain, they outlined a specific psychological profile associated with endometriosis. Each patient completed six standardized psychometric questionnaires, and the results showed that patients with endometriosis showed scores with psychoticism, introversion, and anxiety compared to women with other gynecological problems.
Also in an other study, out of 166 women with endometriosis, in which quality of life, depression, anxiety and anger were studied, it was found that those who had this pathology presented high levels of anxiety and a significant decline in the quality of life.