{"paper_id":"e1e41fb1-746c-43a6-9c54-131d8b8c6a3f","body_text":"Endometriosis Beyond the Body: A Review of Its Impact on Mental Health, Sexual Function, and Fertility\nDOI:\nhttps://doi.org/10.12775/QS.2026.57.72473Keywords\nendometriosis, quality of life, infertility, Mental health, SexualityAbstract\nIntroduction:\nEndometriosis is a chronic, hormone-dependent condition affecting up to 15% of women of reproductive age. It is associated with pain, infertility, and a significant reduction in quality of life. Despite increasing awareness, the average diagnostic delay remains between 7 and 11 years. The disease is characterized by chronic pelvic pain, fatigue, dyspareunia, and emotional distress, which may contribute to depression, anxiety, decreased self-esteem, and social isolation. Sexual dysfunction arises from both physical symptoms and psychological factors. Endometriosis is also recognized as a leading cause of infertility.\nObjective:\nThe aim of this review is to evaluate the impact of endometriosis on women’s mental health, sexual functioning, and fertility, with particular emphasis on diagnostic delays and social stigma.\nMethods and materials:\nA literature review was conducted using publications available in the PubMed and Google Scholar databases from 2017-2025. The most relevant and recent studies were selected using appropriate keywords.\nConclusions:\nEndometriosis requires a holistic and multidisciplinary approach that integrates medical management with psychological and sexual health support. Addressing mental health and social well-being is essential for improving overall quality of life in affected women. Early diagnosis and the reduction of stigma remain key challenges in contemporary clinical practice.\nReferences\n1. Ruszała M, Dłuski DF, Winkler I, Kotarski J, Rechberger T, Gogacz M. The State of\nHealth and the Quality of Life in Women Suffering from Endometriosis. J Clin Med.\n2022 Apr 6;11(7):2059. doi: 10.3390/jcm11072059. PMID: 35407668; PMCID:\nPMC8999939.\n2. Laganà AS, La Rosa VL, Rapisarda AMC, Valenti G, Sapia F, Chiofalo B, Rossetti D,\nBan Frangež H, Vrtačnik Bokal E, Vitale SG. Anxiety and depression in patients with\nendometriosis: impact and management challenges. Int J Womens Health. 2017 May\n16;9:323-330. doi: 10.2147/IJWH.S119729. PMID: 28553145; PMCID:\nPMC5440042.\n3. Della Corte L, Di Filippo C, Gabrielli O, Reppuccia S, La Rosa VL, Ragusa R,\nFichera M, Commodari E, Bifulco G, Giampaolino P. The Burden of Endometriosis\non Women's Lifespan: A Narrative Overview on Quality of Life and Psychosocial\nWellbeing. Int J Environ Res Public Health. 2020 Jun 29;17(13):4683. doi:\n10.3390/ijerph17134683. PMID: 32610665; PMCID: PMC7370081.\n4. Maulenkul, T., Kuandyk, A., Makhadiyeva, D. et al. Understanding the impact of\nendometriosis on women’s life: an integrative review of systematic reviews. BMC\nWomen's Health 24, 524 (2024). https://doi.org/10.1186/s12905-024-03369-5\n5. Márki G, Bokor A, Rigó J, Rigó A. Physical pain and emotion regulation as the main\npredictive factors of health-related quality of life in women living with endometriosis.\nHum Reprod. 2017 Jul 1;32(7):1432-1438. doi: 10.1093/humrep/dex091. PMID:\n28482063.\n6. Facchin F, Barbara G, Dridi D, Alberico D, Buggio L, Somigliana E, Saita E,\nVercellini P. Mental health in women with endometriosis: searching for predictors of\npsychological distress. Hum Reprod. 2017 Sep 1;32(9):1855-1861. doi:\n10.1093/humrep/dex249. PMID: 28854724.\n7. Nnoaham KE, Hummelshoj L, Webster P, et al. Impact of endometriosis on quality of\nlife and work productivity: a multicenter study across ten countries. Fertil Steril.\n2011;96(2):366-373.\n8. De Corte P, Klinghardt M, von Stockum S, Heinemann K. Time to Diagnose\nEndometriosis: Current Status, Challenges and Regional Characteristics-A Systematic\nLiterature Review. BJOG. 2025 Jan;132(2):118-130. doi: 10.1111/1471-0528.17973.\nEpub 2024 Oct 7. Erratum in: BJOG. 2025 Jun;132(7):1018. doi:\n10.1111/1471-0528.18149. PMID: 39373298; PMCID: PMC11625652.\n9. Grigoriadis G, Roman H, Kalaitzopoulos DR, Christoforidis N, Pados G, Daniilidis\nA. Diagnosis of Endometriosis by Transvaginal Ultrasound: An Online Survey of\nGynecologists Practising in Greece. Cureus. 2023 Apr 21;15(4):e37950. doi:\n10.7759/cureus.37950. PMID: 37220449; PMCID: PMC10200312.\n10. Sims OT, Gupta J, Missmer SA, Aninye IO. Stigma and Endometriosis: A Brief\nOverview and Recommendations to Improve Psychosocial Well-Being and Diagnostic\nDelay. Int J Environ Res Public Health. 2021 Aug 3;18(15):8210. doi:\n10.3390/ijerph18158210. PMID: 34360501; PMCID: PMC8346066.\n11. Fryer J, Mason-Jones AJ, Woodward A. Understanding diagnostic delay for\nendometriosis: A scoping review using the social-ecological framework. Health Care\nWomen Int. 2025;46(3):335-351. doi: 10.1080/07399332.2024.2413056. Epub 2024\nOct 17. PMID: 39418593.\n12. Ozkan S, Murk W, Arici A. Endometriosis and infertility: epidemiology and\nevidence-based treatments. Ann N Y Acad Sci. 2008 Apr;1127:92-100. doi:\n10.1196/annals.1434.007. PMID: 18443335.\n13. Filip L, Duică F, Prădatu A, Crețoiu D, Suciu N, Crețoiu SM, Predescu DV , Varlas\nVN, V oinea SC. Endometriosis Associated Infertility: A Critical Review and Analysis\non Etiopathogenesis and Therapeutic Approaches. Medicina (Kaunas). 2020 Sep\n9;56(9):460. doi: 10.3390/medicina56090460. PMID: 32916976; PMCID:\nPMC7559069.\n14. Broi MGD, Ferriani RA, Navarro PA. Ethiopathogenic mechanisms of\nendometriosis-related infertility. JBRA Assist Reprod. 2019 Aug 22;23(3):273-280.\ndoi: 10.5935/1518-0557.20190029. PMID: 31091056; PMCID: PMC6724396.\n15. Kutlesic R, Kutlesic M, Milosevic-Stevanovic J, Vukomanovic P, Stefanovic M,\nMostic-Stanisic D. Prolactin and Hyperprolactinaemia in Endometriosis-Related\nInfertility: Are There Clinically Significant Connections? Journal of Clinical\nMedicine. 2024; 13(19):5868. https://doi.org/10.3390/jcm13195868\n16. Esmaeilzadeh S, Mirabi P, Basirat Z, Zeinalzadeh M, Khafri S. Association between\nendometriosis and hyperprolactinemia in infertile women. Iran J Reprod Med. 2015\nMar;13(3):155-60. PMID: 26000006; PMCID: PMC4426155.\n17. Frontiers | Update on the pathogenesis of endometriosis-related infertility based on\ncontemporary evidence. Front Endocrinol (Lausanne). 2025;16:1558271.\ndoi:10.3389/fendo.2025.1558271.\n18. Dmowski WP, Rao R, Scommegna A. The luteinized unruptured follicle syndrome\nand endometriosis. Fertil Steril. 1980 Jan;33(1):30-4. doi:\n10.1016/s0015-0282(16)44473-0. PMID: 7351255.\n19. Bonavina G, Taylor HS. Endometriosis-associated infertility: From pathophysiology\nto tailored treatment. Front Endocrinol (Lausanne). 2022 Oct 26;13:1020827. doi:\n10.3389/fendo.2022.1020827. PMID: 36387918; PMCID: PMC9643365.\n20. van Poll M, van Barneveld E, Aerts L, et al. Endometriosis and Sexual Quality of\nLife. Sex Med. 2020;8(4):532–44. doi:10.1016/j.esxm.2020.05.001.\n21. Wang Y , Li B, Zhou Y , Wang Y , Han X, Zhang S, He Z, Ouyang L. Does\nEndometriosis Disturb Mental Health and Quality of Life? A Systematic Review and\nMeta-Analysis. Gynecol Obstet Invest. 2021;86(4):315-335. doi: 10.1159/000516517.\nEpub 2021 Aug 5. PMID: 34352799.\n22. Barbara G, Facchin F, Meschia M, Berlanda N, Frattaruolo MP, VercellinI P. When\nlove hurts. A systematic review on the effects of surgical and pharmacological\ntreatments for endometriosis on female sexual functioning. Acta Obstet Gynecol\nScand. 2017 Jun;96(6):668-687. doi: 10.1111/aogs.13031. Epub 2016 Nov 5. PMID:\n27687240.\n23. Pereira MG, Ribeiro I, Ferreira H, Osório F, Nogueira-Silva C, Almeida AC.\nPsychological Morbidity in Endometriosis: A Couple's Study. Int J Environ Res\nPublic Health. 2021 Oct 10;18(20):10598. doi: 10.3390/ijerph182010598. PMID:\n34682344; PMCID: PMC8535360.\n24. Machairiotis N, Genazzani A. Endometriosis: A Comprehensive Analysis of the\nPathophysiology, Treatment, and Nutritional Aspects, and Its Repercussions on the\nQuality of Life of Patients. Biomedicines. 2024;12(7):1476.\ndoi:10.3390/biomedicines12071476.\n25. Wang Y , Nicholes K, Shih IM. The Origin and Pathogenesis of Endometriosis. Annu\nRev Pathol. 2020 Jan 24;15:71-95. doi:\n10.1146/annurev-pathmechdis-012419-032654. Epub 2019 Sep 3. PMID: 31479615;\nPMCID: PMC7980953.\n26. Gruber TM, Mechsner S. Pathogenesis of Endometriosis: The Origin of Pain and\nSubfertility. Cells. 2021 Jun 3;10(6):1381. doi: 10.3390/cells10061381. PMID:\n34205040; PMCID: PMC8226491.\n27. Giudice LC. Clinical practice. Endometriosis. N Engl J Med. 2010 Jun\n24;362(25):2389-98. doi: 10.1056/NEJMcp1000274. PMID: 20573927; PMCID:\nPMC3108065.\n28. Practice Committee of the American Society for Reproductive Medicine.\nEndometriosis and infertility: a committee opinion. Fertil Steril. 2012\nSep;98(3):591-8. doi: 10.1016/j.fertnstert.2012.05.031. Epub 2012 Jun 15. PMID:\n22704630.\n29. Omtvedt M, Bean E, Hald K, Larby ER, Majak GB, Tellum T. Patients' and relatives'\nperspectives on best possible care in the context of developing a multidisciplinary\ncenter for endometriosis and adenomyosis: findings from a national survey. BMC\nWomens Health. 2022 Jun 10;22(1):219. doi: 10.1186/s12905-022-01798-8. PMID:\n35689259; PMCID: PMC9188072.\n30. Lorençatto C, Petta CA, Navarro MJ, Bahamondes L, Matos A. Depression in women\nwith endometriosis with and without chronic pelvic pain. Acta Obstet Gynecol Scand.\n2006;85(1):88-92. doi: 10.1080/00016340500456118. PMID: 16521687.\n31. Fourquet J, Gao X, Zavala D, Orengo JC, Abac S, Ruiz A, Laboy J, Flores I. Patients'\nreport on how endometriosis affects health, work, and daily life. Fertil Steril. 2010\nMay 1;93(7):2424-8. doi: 10.1016/j.fertnstert.2009.09.017. PMID: 19926084;\nPMCID: PMC2860000.\n32. Rempert AN, Rempert TH, Liu A, Hernández A, Blanck J, Segars J, Singh B. A\nSystematic Review of the Psychosocial Impact of Endometriosis before and after\nTreatment. Reprod Sci. 2024 Jul;31(7):1828-1860. doi:\n10.1007/s43032-024-01515-w. Epub 2024 Mar 21. PMID: 38512699; PMCID:\nPMC11216884.\n33. Ramin-Wright A, Schwartz ASK, Geraedts K, Rauchfuss M, Wölfler MM, Haeberlin\nF, von Orelli S, Eberhard M, Imthurn B, Imesch P, Fink D, Leeners B. Fatigue - a\nsymptom in endometriosis. Hum Reprod. 2018 Aug 1;33(8):1459-1465. doi:\n10.1093/humrep/dey115. PMID: 29947766.\n34. Vaghar MI. Evaluation of lifestyle and endometriosis in infertile women referring to\nthe selected hospital of Tehran University Medical Sciences. J Family Med Prim Care.\n2019 Nov 15;8(11):3574-3577. doi: 10.4103/jfmpc.jfmpc_496_19. PMID: 31803655;\nPMCID: PMC6881964.\n35. Lee J, Park HJ, Yi KW. Dienogest in endometriosis treatment: A narrative literature\nreview. Clin Exp Reprod Med. 2023 Dec;50(4):223-229. doi:\n10.5653/cerm.2023.06128. Epub 2023 Oct 24. PMID: 37995750; PMCID:\nPMC10711247.\n36. Bafort C, Beebeejaun Y , Tomassetti C, Bosteels J, Duffy JM. Laparoscopic surgery\nfor endometriosis. Cochrane Database Syst Rev. 2020 Oct 23;10(10):CD011031. doi:\n10.1002/14651858.CD011031.pub3. PMID: 33095458; PMCID: PMC8428328.\n37. Barbara G, Buggio L, Facchin F, Vercellini P. Medical Treatment for Endometriosis:\nTolerability, Quality of Life and Adherence. Front Glob Womens Health. 2021 Sep\n27;2:729601. doi: 10.3389/fgwh.2021.729601. PMID: 34816243; PMCID:\nPMC8594049.\n38. Kaveh M, Malakouti H, Chaichian S, Kashi AM, Afshari M, Sadegi K. Evaluation of\nlaparoscopic surgery effects on pain severity and quality of life in different subtypes\nof endometriosis: A follow-up study. Int J Reprod Biomed. 2025 May\n1;23(2):199-206. doi: 10.18502/ijrm.v23i2.18494. PMID: 40371363; PMCID:\nPMC12070047.\nDownloads\nPublished\nHow to Cite\nIssue\nSection\nLicense\nCopyright (c) 2026 Gabriela Babiarz, Damian Osiński, Zuzanna Kawa, Maria Kasprzak, Aleksandra Jędrzejewska, Aleksandra Jureczko, Klaudia Kleczaj, Łukasz Starczewski, Julia Jaworowska, Julia Kanarszczuk\nThis work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.\nStats\nNumber of views and downloads: 34\nNumber of citations: 0","source_license":"CC0","license_restricted":false}