Endometriosis and Pelvic Pain? Consider Psychological Intervention, Study Says

Endometriosis and Pelvic Pain? Consider Psychological Intervention, Study Says

Women who suffer from pelvic pain caused by endometriosis may need psychological intervention to help improve both mental health and quality of life, says a new study in the Journal of Psychosomatic Obstetrics & Gynecology.

The study examined the impact of endometriosis on quality of life, anxiety and depression. In total, 110 women with surgically diagnosed endometriosis (with and without pelvic pain) and 61 health controls were studied.  The researchers found that those who experience pelvic pain had poorer mental health than those who did not.

Notable results from the study include:

  • Women with endometriosis (no pain) are less likely to experience anxiety and depression than those who have pelvic pain.
  • Pain is the key aspect to poorer mental health, which is critical to understand when devising treatment plans for women with endometriosis.

“Not only do we know just how much impact pelvic pain can have on quality of life, but we’ve also learned that different types of endometriosis pain (dysmenorrhea, dyspareunia, non-menstrual pelvic pain and dyschezia) can affect mental health in different ways,” a spokesperson from Taylor & Francis, publisher of The Journal of Psychosomatic Obstetrics & Gynecology said.

“This means that in assessing patient symptoms and pain types, doctors will be able to provide them with the most appropriate type of psychological intervention to improve their quality of life,” the spokesperson added.

“Pain significantly affects women’s experience of endometriosis. The medical treatment of endometriosis with pain may not be sufficient and psychological intervention is recommended,” the study’s authors concluded, in their article, Impact of endometriosis on quality of life and mental health: pelvic pain makes the difference.

Endometriosis is a painful disorder where the tissues that lines the uterus grows outside of the uterus, and may involve the ovaries, pelvis and bowels.  It is associated with heavy menstrual cycles, pelvic pain, and typically affects girls and women during their productive years.  Endometriosis is most commonly treated surgically, while symptoms are often managed with oral contraceptives, pain medicine and GnRH therapy.

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“All pain problems, by the natural laws of biology, must have a reasonable cause, a pathological source, a location in the body, a matched solution that will benefit the pain source and an access point from which to “touch” the pain source thus resulting in a resolution of the pain.” -Cyriax-modified

If you are living in long-term pain that has not been eradicated with medications or surgery, by default, this pain has come from somewhere! The most likely and common location of all invisible aches, pains, stiffness and dysfunctions is within the soft, connective and muscle tissues. Soft tissues can only healed from within by natural forces. These tissues stale out healing so they need an additional force applied by either human or mechanical touch or assisted tools. This extra force activates the natural forces from within which is the only healer of dis-eases. Hippocrates. Meds and surgery cannot effectively and safely touch activate this healing.

The default treatments of soft tissues come in the form of old-school hands-on physician therapy. Here is a prescription that I been using which is made up of oldies and still goodies standards from the middle of the last century:
The patient’s responsibility: STRETCHING with range of motion IS MANDATORY PART OF THE RECIPE. This should be done at least 3 times per day. Self massages, aerobic exercise programs, Tai Chi and/or Yoga. Epsom Salts baths.
I ask pts to avoid: Raw simple sugar foods and Highly refined starches.

For the patient’s Helpers: Hands-on options @ 2-3 x per week: a) Massage. b) Tissue release options. c) strain and counter-strain. d) Joint Manipulations.

If you are not making progress toward a better state then you must up the ante:
These tools can reach farther into the soft tissues to stimulate deeper and more aggressively without doing additional harm: Thin intramuscular needling options @ 2-3 x per week: a) Dry needling b) GunnIMS c) Chinese, Japanese, French Energetic and various other “Acupuncture.” Wet Needling aka Tender Point Stimulative Needling.

The goal is to active and fuel the natural forces which will “whittle down” as much of the soft and intramuscular tissue damages. This allows these tissues to be able to automatically rebuilt back to healthy. This is not a quick fix, it may take 6 to 24 months or up to 2-4 years of diligent work. A lot - yes. Not impossible w persistence and good crew members.

Most of these treatments have been taken away from you over the past 2 decades and left your only with pills and the knife. If you wish to advocate for yourself, call your members of Government, Congress ie HHS to put them back on front of the stoves.


@Jeremy Goodwin, MS, MD
I am not a professional nor am I an educated neurologist. In fact, as a male this is something I cannot comment on but I am a life-long chronic pain sufferer and am willing to share my feelings. At age 60, after trying every intervention under the sun, I finally went to a well-known pain specialist and now I’m 65 and have had the best 5 years of my life as far as quality of life goes. I went to quite a few psychologists/psychiatrists for evaluation usually as I would try a new therapy with a new treatment plan. Once was enough!!!!! The continuous “interventions to help me cope” got old very fast. After seeing the pattern, it seemed that going thru these interventions was a way of saying “I do not know why you hurt so bad SO, it’s ALL IN YOU HEAD.” Experience taught me the obvious coping skills, not redundant visits to a shrink. It got to where it seemed a game I had to play to try any treatment until I was put on opioid therapy. Now I am functioning better and enjoying life. I am not saying that psychological intervention is useless but ENOUGH WAS ENOUGH!!!!!!!!!

Jeremy Goodwin, MS, MD

As a fellowship trained and educated neurologist, Ineas taught that all such life affecting chronically ( recurrent-acute) painful conditions automatically include and require psychological intervention to help cope with the pain and stress. Has something happened that this is no longer standard with multi-modal and interdisciplinary care of such disorders?