Abstract
Women with endometriosis are often under stress due to the associated pain, infertility, inflammation-related and other comorbidities including cancer. Additionally, these women are also under stress due to taboos, myths, inter-personal troubles surrounding infertility and pain of the disease as well as due to frequent incidences of missed diagnosis and treatment recurrence. Often these women suffer from frustration and loss of valuable time in the prime phase of life. All these complexities integral to endometriosis posit a hyperstructure of integrative stress physiology with overt differentials in effective allostatic state in women with disease compared with disease-free women. In the present review, we aim to critically examine various aspects of pathophysiological basis of stress surrounding endometriosis with special emphasis on pain and subfertility that are known to affect the overall health and quality of life of women with the disease and promising pathophysiological basis for its effective management.
Highlights
Endometriosis occurs due to the growth of endometrium-like tissue outside the uterus
Several studies indicated that long-term pharmacological treatment for endometriosis offers symptomatologic relief up to 70% of women suffering from pelvic pain, there exists very little curative treatments to provide sufficient relief from endometriosis, and surgical treatments most often result in high rates of recurrence [43], which adversely affect patient’s psychosocial wellbeing and quality of life with an associated relative increase in the total healthcare spending due to the presence of comorbidities [24,38,44]
Despite limitations typically noted in a narrative review, a few of the important conceptual issues regarding endometriosis-linked stress identified in the presents review appear to be meaningful to the stake holders
Summary
Endometriosis occurs due to the growth of endometrium-like tissue outside the uterus. It is a complex disorder that is influenced by genetic, epigenetic and environmental factors [1,2,3,4,5]. Endometrial cells, stem cells and bone marrow cells with genetic and epigenetic defects after implantation and metaplasia within an abnormal environment of the peritoneal cavity progress to form the typical ectopic lesions in ovary, peritoneum and rectovaginal compartments [6,7]. Endometriosis is associated with chronic inflammatory disorder state along with pelvic pain affecting 10–15% women during their reproductive years, as well as with primary infertility in 50% women [8,9,10].
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