People with endometriosis report high levels of stress. Living with the condition can cause stress, and experiencing stress can both trigger symptoms and make them worse.

Research shows that endometriosis and stress are interrelated.

In one study of people with endometriosis, 68% of participants reported living with mild or high levels of stress. While it can be difficult to disentangle cause and effect, animal studies suggest that stress can accelerate the development and growth of endometriosis lesions.

Animal studies have also recently demonstrated that stress increases the size and severity of the lesions as well as inflammatory parameters.

Stress can make pain worse, potentially intensifying a person’s endometriosis symptoms and affecting their quality of life.

Read on to learn more about the link between endometriosis and stress.

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People living with endometriosis report higher levels of stress than people without the condition. The relationship between stress and endometriosis, though, is a complicated one.

Endometriosis is a painful chronic condition that can affect fertility, quality of life, and a person’s ability to pursue hobbies and career goals. A person may need to take time off work or school because of their symptoms.

Consequently, people with endometriosis report higher levels of stress than average.

A 2020 study found that stress levels correlated with the endometriosis stage. For example, more advanced stages of the condition corresponded with higher levels of stress.

Animal studies suggest that in addition to causing high stress, the stress itself may worsen endometriosis.

In a 2016 study, for example, researchers induced endometriosis in rats and then exposed the rats to stress. The stress accelerated the development of endometriosis lesions.

Another 2020 animal study found that inflammatory markers were higher in stressed rats and that this correlated with worsening endometriosis. It also found that inflammation in adipose (fat) tissue might play a role in the development of endometriosis.

However, researchers have also recently found that in addition to worsening the inflammatory markers of endometriosis, stress may have an impact on the size and severity of the lesions themselves.

The body and brain are not separate entities, and a person’s emotions affect their body.

Researchers still do not understand the precise mechanism that causes endometriosis to develop, but they think that inflammation and oxidative damage play a role. Stress can increase and accelerate both.

A 2020 review highlights how stress hormones can trigger a cascade of inflammation.

Endometriosis itself is stressful, with 68% of people with endometriosis reporting moderate or high stress levels. A 2018 meta-analysis also found a link between endometriosis and mental health, reporting higher levels of depression among people with endometriosis, especially when they also experience pelvic pain.

This increase in stress due to endometriosis symptoms may then further accelerate endometriosis. The cycle can make it difficult to disentangle whether endometriosis causes or results from stress.

Endometriosis flares vary from person to person. Anecdotally, many people report that lifestyle issues that increase inflammation — such as drinking too much alcohol or experiencing high levels of stress — may make symptoms worse.

Hormonal changes can affect endometriosis, too, since estrogen plays an important role.

People may experience worsening symptoms after going off of birth control or notice that their symptoms change during breastfeeding or throughout their reproductive years. Logging symptoms and potential triggers may help a person develop a personalized treatment plan.

Managing stress can make it easier to manage the pain of endometriosis. Some strategies that may help include:

  • working with a psychotherapist who has experience with chronic pain conditions
  • partnering with a doctor who has experience managing endometriosis symptoms
  • asking for accommodations at work or school
  • advocating for oneself

Giving a doctor detailed information about symptoms and medical history may help a person get better treatment. Some questions to ask include:

  • What are my options if I want to become pregnant?
  • How may lifestyle changes affect endometriosis?
  • What can we do if treatment is not working?
  • How long should I wait for treatment to work?
  • When should we consider surgery?
  • How severe is my endometriosis?

Living with endometriosis can be challenging. Stress may also intensify the severity of endometriosis flares, making the disease more difficult to manage and live with.

The right treatment can reduce pain and stress.

Psychological support is also important because it can help a person advocate for better treatment and learn to live with endometriosis.