Document Type : Review Article


Clinical and Health Psychology, Department of Dynamical, Clinical and Health Psychology, Sapienza University, School of Specialization in Health Psychology, Rome, Italy


Context: Endometriosis is a chronic condition affecting 10% of women in their reproductive age worldwide. Endometriosis symptoms can seriously impact the quality of life and the mental health of women. Although it could be found in over 60% of adolescent girls and adolescents may suffer from advanced forms of it, there are not enough studies on psychological impacts of endometriosis in adolescence.
Evidence acquisition: In this narrative review study, research studies and systematic review studies conducted from 2000 to 2021 were searched in the PubMed, Medline, and Scopus with the following keywords: “young women OR adolescents OR adolescence” AND “endometriosis” AND “psychologic* OR emotions OR well-being OR quality of life”.
Results: Endometriosis symptoms substantially affect the psychological well-being of young women. They often report physical pain, reduced general health and vitality, poor physical and social functioning, as well as limitations in emotional functioning.
Conclusions: These data highlighted the need for increased awareness concerning this disease for its early diagnosis and focused on healthcare assistance and psychological support for adolescent girls with this condition.


1. Chapron C, Marcellin L, Borghese B, Santulli P. Rethinking mechanisms, diagnosis and management of endometriosis. Nat Rev Endocrinol. 2019;15(11):666-682. doi: 10.1038/s41574-019-0245-z. PubMed PMID: 31488888. ## 2. As-Sanie S, Black R, Giudice LC, Gray Valbrun T, Gupta J, Jones B, et al. Assessing research gaps and unmet needs in endometriosis. Am J Obstet Gynecol. 2019;221(2):86-94. doi: 10.1016/j.ajog.2019.02.033. PubMed PMID: 30790565. ## 3. Vetvicka V, Laganà AS, Salmeri FM, Triolo O, Palmara VI, Vitale SG, et al. Regulation of apoptotic pathways during endometriosis: from the molecular basis to the future perspectives. Arch Gynecol Obstet. 2016;294(5):897-904. doi: 10.1007/s00404-016-4195-6. PubMed PMID: 27628753. ## 4. Laganà AS, La Rosa VL, Rapisarda AMC, Valenti G, Sapia F, Chiofalo B, et al. Anxiety and depression in patients with endometriosis: Impact and management challenges. Int J Womens Health. 2017;9:323–330. doi: 10.2147/IJWH.S119729. PubMed PMID: 28553145; PubMed Central PMCID: PMC5440042. ## 5. Vitale SG, Capriglione S, Peterlunger I, La Rosa VL, Vitagliano A, Noventa M, et al. The role of oxidative stress and membrane transport systems during endometriosis: a fresh look at a busy corner. Oxid Med Cell Longev. 2018;2018:7924021. doi: 10.1155/2018/7924021. PubMed PMID: 29743986; PubMed Central PMCID: PMC5883985. ## 6. La Rosa VL, De Franciscis P, Barra F, Schiattarella A, Tropea A, Tesarik J, et al. Sexuality in women with endometriosis: A critical narrative review. Minerva Med. 2020;111(1):79-89. doi: 10.23736/S0026-4806.19.06299-2. PubMed PMID: 31726815. ## 7. La Rosa VL, Barra F, Chiofalo B, Platania A, Di Guardo F, Conway F, et al. An overview on the relationship between endometriosis and infertility: The impact on sexuality and psychological well-being. J Psychosom Obstet Gynaecol. 2020;41(2):93-97. doi: 10.1080/0167482X.2019.1659775. PubMed PMID: 31466493. ## 8. Culley L, Law C, Hudson N, Denny E, Mitchell H, Baumgarten M, Raine-Fenning N. The social and psychological impact of endometriosis on women's lives: a critical narrative review. Hum Reprod Update. 2013;19(6):625-39. doi: 10.1093/humupd/dmt027. PubMed PMID: 23884896. ## 9. De Graaff AA, D’Hooghe TM, Dunselman GAJ, Dirksen CD, Hummelshoj L, WERF EndoCost Consortium, Simoens S. The significant effect of endometriosis on physical, mental and social wellbeing: Results from an international cross-sectional survey. Hum. Reprod. 2013;28(10):2677–85. doi: 10.1093/humrep/det284. PubMed PMID: 23847114. ## 10. Rush G, Misajon R. Examining subjective wellbeing and health-related quality of life in women with endometriosis. Health Care Women Int. 2018;39(3):303–321. doi: 10.1080/07399332.2017.1397671. PubMed PMID: 29095116. ## 11. Della Corte L, Di Filippo C, Gabrielli O, Reppuccia S, La Rosa VL, Ragusa R, et al. The Burden of Endometriosis on Women's Lifespan: A Narrative Overview on Quality of Life and Psychosocial Wellbeing. Int J Environ Res Public Health. 2020;17(13):4683. doi: 10.3390/ijerph17134683. PubMed PMID: 32610665; PubMed Central PMCID: PMC7370081. ## 12. Sarıdogan E. Endometriosis in teenagers. Womens Health. 2015;11(5):705-9. doi: 10.2217/whe.15.58. PubMed PMID: 26315257. ## 13. Hudelist G, Fritzer N, Thomas A, Niehues C, Oppelt P, Haas D, et al. Diagnostic delay for endometriosis in Austria and Germany: Causes and possible consequences. Hum Reprod. 2012;27(12), 3412–6. doi: 10.1093/humrep/des316. PubMed PMID: 22990516. ## 14. Gilmour JA, Huntington A, Wilson HV. The impact of endometriosis on work and social participation. Int J Nurs Pract. 2008;14(6):443–8. doi: 10.1111/j.1440-172X.2008.00718.x. PubMed PMID: 19126072. ## 15. Soliman AM, Coyne KS, Gries KS, Castelli-Haley J, Snabes MC, Surrey ES. The Effect of Endometriosis Symptoms on Absenteeism and Presenteeism in the Workplace and at Home. J Manag Care Spec Pharm. 2017;23(7):745–754. doi: 10.18553/jmcp.2017.23.7.745. PubMed PMID: 28650252. ## 16. Marinho MCP, Magalhaes TF, Fernandes LFC, Augusto KL, Brilhante AVM, Bezerra LRPS. Quality of Life in Women with Endometriosis: An Integrative Review. J Womens Health. 2018;27(3):399–408. doi: 10.1089/jwh.2017.6397. PubMed PMID: 29064316. ## 17. Seear K. The etiquette of endometriosis: Stigmatisation, menstrual concealment and the diagnostic delay. Soc Sci Med. 2009;69(8):1220–7. doi: 10.1016/j.socscimed.2009.07.023. PubMed PMID: 19699572. ## 18. Chen LC, Hsu JW, Huang KL, Bai YM, Su TP, Li CT, et al. Risk of developing major depression and anxiety disorders among women with endometriosis: A longitudinal follow-up study. J Affect Disord. 2016;190:282–285. doi: 10.1016/j.jad.2015.10.030. PubMed PMID: 26544610. ## 19. Jones G, Jenkinson C, Kennedy S. The impact of endometriosis upon quality of life: a qualitative analysis. Psychosom Obstet Gynaecol. 2004;25(2):123-33. doi: 10.1080/01674820400002279. PubMed PMID: 15715035. ## 20. Bernuit D, Ebert AD, Halis G, Strothmann A, Gerlinger C, Geppert K, et al. Female perspectives on endometriosis: Findings from the uterine bleeding and pain women’s research study. Journal of Endometriosis and Pelvic Pain Disorders. 2011;3(2):73–85. doi: 10.5301/JE.2011.8525. ## 21. Vercellini P, Somigliana E, Buggio L, Barbara G, Frattaruolo MP, Fedele L. “I can’t get no satisfaction”: Deep dyspareunia and sexual functioning in women with rectovaginal endometriosis. Fertil Steril. 2012;98(6):1503–11. doi: 10.1016/j.fertnstert.2012.07.1129. PubMed PMID: 22910685. ## 22. Shum LK, Bedaiwy MA, Allaire C, Williams C, Noga H, Albert A, et al. Deep Dyspareunia and Sexual Quality of Life in Women With Endometriosis. Sex Med. 2018;6(3):224–233. doi: 10.1016/j.esxm.2018.04.006. PubMed PMID: 29801714; PubMed Central PMCID: PMC6085224. ## 23. Bernays V, Schwartz AK, Geraedts K, Rauchfuss M, Wolfler MM, Haeberlin F, et al. Qualitative and quantitative aspects of sex life in the context of endometriosis: a multicentre case control study. Reprod Biomed Online. 2020;40(2):296–304. doi: 10.1016/j.rbmo.2019.10.015. PubMed PMID: 31954612. ## 24. Moradi M, Parker M, Sneddon A, Lopez V, Ellwood D. Impact of endometriosis on women’s lives: a qualitative study. BMC Womens Health. 2014;14:123. doi: 10.1186/1472-6874-14-123. PubMed PMID: 25280500; PubMed Central PMCID: PMC4287196. ## 25. Damon W, Hart D. Self-Understanding in Childhood and Adolescence. Cambridge, GB, Cambridge University Press; 1991. ## 26. Kornienko O, Santos CE, Martin CL, Granger KL. Peer influence on gender identity development in adolescence. Dev Psychol. 2016;52(10):1578-1592. doi: 10.1037/dev0000200. PubMed PMID: 27584667. ## 27. Erikson, EH. Identity, youth and crisis. New York, USA, Norton & Company; 1968. ## 28. Chan KW, Chan SM. Emotional Autonomy versus susceptibility to peer pressure a case study of Hong Kong adolescent students. Research in Education. 2008;79(1):39–55. doi: 10.7227/RIE.79.4. ## 29. Alonso-Stuyck P, Zacarés JJ, Ferreres A. Emotional Separation, Autonomy in Decision-Making, and Psychosocial Adjustment in Adolescence: A Proposed Typology. J Child Fam Stud. 2018;27(5):1373–1383. doi: 10.1007/s10826-017-0980-5. ## 30. Taylor RM, Gibson F, Franck LS. The experience of living with a chronic illness during adolescence: a critical review of the literature. J Clin Nurs. 2008;17(23):3083-91. doi: 10.1111/j.1365-2702.2008.02629.x. PubMed PMID: 19012778. ## 31. Griggs S., Walker RK. The Role of Hope for Adolescents with a Chronic Illness: An Integrative Review. J Pediatr Nurs. 2016;31(4):404-21. doi: 10.1016/j.pedn.2016.02.011. PubMed PMID: 27021596. ## 32. Lum A, Wakefield CE, Donnan B, Burns MA, Fardell JE, Marshall GM. Understanding the school experiences of children and adolescents with serious chronic illness: a systematic meta-review. Child Care Health Dev. 2017;43(5):645-662. doi: 10.1111/cch.12475. PubMed PMID: 28543609. ## 33. Bodén E, Wendel C, Adolfsson A. Adolescents with endometriosis: Their experience of the school health care system in Sweden. British Journal of School Nursing. 2013;8(2):81-87. doi: 10.12968/bjsn.2013.8.2.81. ## 34. Rowlands IJ, Teede H, Lucke J, Dobson AJ, Mishra GD. Young women's psychological distress after a diagnosis of polycystic ovary syndrome or endometriosis. Hum Reprod. 2016;31(9):2072-81. doi: 10.1093/humrep/dew174. PubMed PMID: 27412249. ## 35. Gupta J, Cardoso LF, Harris CS, Dance AD, Seckin T, Baker N, et al How do adolescent girls and boys perceive symptoms suggestive of endometriosis among their peers? Findings from focus group discussions in New York City. BMJ Open. 2018;8(6):e020657. doi: 10.1136/bmjopen-2017-020657. PubMed PMID: 29866728; PubMed Central PMCID: PMC5988150. ## 36. Gallagher JS, DiVasta AD, Vitonis AF, Sarda V, Laufer MR, Missmer SA. The Impact of Endometriosis on Quality of Life in Adolescents. J Adolesc Health. 2018;63(6):766-772. doi: 10.1016/j.jadohealth.2018.06.027. PubMed PMID: 30454733. ## 37. González-Echevarría AM, Rosario E, Acevedo S, Flores I. Impact of coping strategies on quality of life of adolescents and young women with endometriosis. J Psychosom Obstet Gynaecol. 2019;40(2):138-145. doi: 10.1080/0167482X.2018.1450384. PubMed PMID: 29648907; PubMed Central PMCID: PMC6185815. ## 38. Schneider MP, Vitonis AF, Fadayomi AB, Charlton BM, Missmer SA, DiVasta AD. Quality of Life in Adolescent and Young Adult Women With Dyspareunia and Endometriosis. J Adolesc Health. 2020;67(4):557-561. doi: 10.1016/j.jadohealth.2020.02.024. PubMed PMID: 32291152. ## 39. Collins AW. More than myth: The developmental significance of romantic relationships during adolescence. Journal of Research on Adolescence. 2003;13(1):1-24. doi: 10.1111/1532-7795.1301001. ## 40. Lövkvist L, Boström P, Edlund M, Olovsoon M. Age-related differences in quality of life in Swedish women with endometriosis. J Women Health. 2016;25(6):646–53. doi: 10.1089/jwh.2015.5403. PubMed PMID: 26788982. ##