A meta-analysis of 24 studies, including 99,614 women, demonstrated higher levels of depression among women with endometriosis compared to unaffected controls. When researchers restricted the analysis to healthy controls, the association between endometriosis and depression was even stronger. Pain seemed to be the primary driver of the association between endometriosis and depression; in fact, rates of depression were similar between women with pelvic pain and endometriosis and women with pelvic pain but no endometriosis.
Without a doubt the relationship between endometriosis and depression is a complicated one. These findings indicate that women with endometriosis, especially those with chronic pain, should be monitored for emergent depressive symptoms. Furthermore, treatment of depression with antidepressants may be less effective without adequate management of pain symptoms.
Ruta Nonacs, MD PhD
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Depression and endometriosis (Contemporary Ob/Gyn)
Gambadauro P, Carli V, Hadlaczky G. Depressive symptoms among women with endometriosis: a systematic review and meta-analysis. Am J Obstet Gynecol. 2019 Mar;220(3):230-241.