Endometriosis, Psychiatric Disorders May Raise the Risk of One Another

Women who have endometriosis have a higher risk of mental illnesses such as depression, anxiety, and substance use disorders (SUDs), suggests a study in the American Journal of Obstetrics and Gynecology. The study also revealed that the opposite may be true: Women who have depression, anxiety, or other mental illnesses may have a higher risk of endometriosis. Endometriosis is an often painful condition that occurs when tissue similar to the lining of the uterus, called the endometrium, grows in other places, such as the fallopian tubes and ovaries.

Menghan Gao, M.Sc., of the Karolinksa Institute in Stockholm and colleagues analyzed data from several Swedish registers to follow all women who were born in Sweden between 1973 and 1990 and who were diagnosed with psychiatric disorders and endometriosis between age 14 years and the year 2016. They found that women with a previous diagnosis of endometriosis had higher rates of bipolar disorder, depressive disorders, anxiety and stress-related disorders, eating disorders, SUDs, personality disorders, and attention-deficit/hyperactivity disorder (ADHD) compared with women who did not have endometriosis. The greatest risk appeared to be for SUDs and depressive disorders: Women with endometriosis had nearly twice the rate of these conditions than their peers without endometriosis.

Women with a history of psychiatric disorders were more likely than those without a such a history to be later diagnosed with endometriosis. Those with anxiety and stress-related disorders had nearly twice the rate of endometriosis as those without these disorders. Those with a history of personality disorders, ADHD, or depressive disorders were also more likely to have endometriosis than those without such a history.

Abnormalities in the immune system may partly explain the relationship between psychiatric disorders and endometriosis, the researchers wrote. “It is believed that immune dysfunctions followed by inflammatory response to the [endometriosis] lesions are key factors in the pathogenesis of endometriosis, and mounting evidence implicates immune dysregulation in the causation of psychiatric disorders,” they wrote.

The researchers added that the psychological and physical suffering caused by endometriosis could amplify mental distress and that medications used to treat endometriosis may influence mental health. They also stated that women with psychiatric disorders are already receiving health care services, which may increase detection of endometriosis, and that undiagnosed symptoms of endometriosis, such as pain that causes psychological distress, may be misdiagnosed as psychiatric disorders.

(Image: iStock/BakiBG)

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