IMPACTO PSICOSOCIAL DE LA ENDOMETRIOSIS: REVISIÓN SOBRE DOLOR CRÓNICO, SEXUALIDAD, INFERTILIDAD Y RELACIONES

Resumen

La endometriosis es una enfermedad ginecológica crónica asociada con dolor persistente, infertilidad y disminución de la calidad de vida, con importantes repercusiones psicosociales que afectan la salud mental, la sexualidad y las relaciones interpersonales. Metodología: Se realizó una revisión integradora de la literatura utilizando las bases de datos PubMed, SciELO, ScienceDirect y SpringerLink. Se incluyeron veintitrés estudios publicados entre 2015 y 2025 en portugués, inglés o español. La selección de los estudios fue realizada de forma independiente por dos revisores, y los datos extraídos se organizaron en hojas de cálculo electrónicas y se analizaron cualitativamente. Resultados: Se encontró una asociación consistente entre el dolor crónico y una mayor prevalencia de ansiedad y depresión. La dispareunia afectó negativamente la función sexual y la intimidad, mientras que la infertilidad intensificó el malestar emocional y los conflictos relacionales. Conclusión: La endometriosis presenta un impacto psicosocial interdependiente, lo que requiere un abordaje interdisciplinario y centrado en la paciente que integre el manejo del dolor, el apoyo psicológico y la atención a la salud sexual y relacional.

 

Biografía del autor/a

Luizie Helena de Souza Coelho, Afya Faculdade de Medicina de Itajubá

Discente de Medicina - Faculdade Afya Medicina de Itajubá, Itajubá, Minas Gerais, Brasil. 

Maria Clara Gomes Junqueira, Faculdade de Medicina de Itajubá

Discente de Medicina - Faculdade Afya Medicina de Itajubá, Itajubá, Minas Gerais, Brasil. 

Lidinei José Alves, Faculdade de Medicina de Itajubá

Médico Ginecologista e Obstetra, Docente de Medicina - Faculdade Afya Medicina de Itajubá, Itajubá, Minas Gerais, Brasil.

 

Referencias

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: https://doi.org/10.1038/s41574-019-0245-z

2. Smolarz B, Szyłło K, Romanowicz H. Endometriosis: epidemiology, classification, pathogenesis, treatment and genetics (review of literature). Int J Mol Sci. 2021;22(19):10554 DOI: https://doi.org/10.3390/ijms221910554

3. Protopapas A, Vlachos DE, Kathopoulis N, Grigoriadis T, Zacharakis D, Athanasiou S, et al. Total laparoscopic hysterectomy in patients with deep endometriosis: different technical and postoperative considerations compared with procedures performed for other benign indications. Taiwan J Obstet Gynecol. 2022;61(2):216-222 DOI: https://doi.org/10.1016/j.tjog.2022.02.007

4. Bulun SE, Yilmaz BD, Sison C, Miyazaki K, Bernardi L, Liu S, et al. Endometriosis. Endocr Rev. 2019;40(4):1048-1079 DOI: https://doi.org/10.1210/er.2018-00242

5. Alderman MH 3rd, Yoder N, Taylor HS. The systemic effects of endometriosis. Semin Reprod Med. 2017;35(3):263-270 DOI: https://doi.org/10.1055/s-0037-1603582

6. Yang ST, Liu CH, Wang PH. Combination of hyaluronic acid and mesenchymal stem cells for treatment of intrauterine adhesions. Taiwan J Obstet Gynecol. 2022;61(1):8-9 DOI: https://doi.org/10.1016/j.tjog.2021.11.004

7. Yang ST, Chang WH, Lee NR, Lai WA, Shen SH, Lee WL, et al. Endometriosis-associated epithelial ovarian cancer is a more complicated disease than previously suspected. Taiwan J Obstet Gynecol. 2021;60(6):1112-1115 DOI: https://doi.org/10.1016/j.tjog.2021.09.027

8. Wang PH, Yang ST, Chang WH, Liu CH, Lee FK, Lee WL. Endometriosis: part I. Basic concept. Taiwan J Obstet Gynecol. 2022;61(6):927-934 DOI: https://doi.org/10.1016/j.tjog.2022.08.002

9. 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: https://doi.org/10.3390/ijerph17134683

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: https://doi.org/10.1080/07399332.2017.1397671

11. De Graaff AA, D’Hooghe TM, Dunselman GAJ, Dirksen CD, Hummelshoj L, Simoens S, et al. The significant effect of endometriosis on physical, mental and social wellbeing: results from an international cross-sectional survey. Hum Reprod. 2013;28(10):2677-2685 DOI: https://doi.org/10.1093/humrep/det284

12. Pessoa de Farias Rodrigues M, Lima Vilarino F, de Souza Barbeiro Munhoz A, da Silva Paiva L, de Alcantara Sousa LV, Zaia V, et al. Clinical aspects and quality of life among women with endometriosis and infertility: a cross-sectional study. BMC Womens Health. 2020;20(1):124 DOI: https://doi.org/10.1186/s12905-020-00987-7

13. Szypłowska M, Tarkowski R, Kułak K. The impact of endometriosis on depressive and anxiety symptoms and quality of life: a systematic review. Front Public Health. 2023;11:1230303 DOI: https://doi.org/10.3389/fpubh.2023.1230303

14. Gao M, Koupil I, Sjöqvist H, Karlsson H, Lalitkumar S, Dalman C, et al. Psychiatric comorbidity among women with endometriosis: a nationwide cohort study in Sweden. Am J Obstet Gynecol. 2020;223(3):415.e1-415.e16 DOI: https://doi.org/10.1016/j.ajog.2020.02.033

15. Kocas HD, Rubin LR, Lobel M. Stigma and mental health in endometriosis. Eur J Obstet Gynecol Reprod Biol X. 2023;19:100228 DOI: https://doi.org/10.1016/j.eurox.2023.100228

16. Aredo JV, Heyrana KJ, Karp BI, Shah JP, Stratton P. Relating chronic pelvic pain and endometriosis to signs of sensitization and myofascial pain and dysfunction. Semin Reprod Med. 2017;35(1):88-97 DOI: https://doi.org/10.1055/s-0036-1597123

17. Fairbanks F, Abdo CH, Baracat EC, Podgaec S. Endometriosis doubles the risk of sexual dysfunction: a cross-sectional study in a large sample of patients. Gynecol Endocrinol. 2017;33(7):544-547 DOI: https://doi.org/10.1080/09513590.2017.1302421

18. 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: https://doi.org/10.1080/0167482X.2019.1659775

19. Tanbo T, Fedorcsak P. Endometriosis-associated infertility: aspects of pathophysiological mechanisms and treatment options. Acta Obstet Gynecol Scand. 2017;96(6):659-667 DOI: https://doi.org/10.1111/aogs.13082

20. Mori L, Vilarino F, Pádua M, Zaia V, Barbosa C. Depression and quality of life in patients with endometriosis and infertility. Fertil Steril. 2017;108(3):e115 DOI: https://doi.org/10.1016/j.fertnstert.2017.07.599

21. Mori LP, Zaia V, Montagna E, Vilarino FL, Barbosa CP. Endometriosis in infertile women: an observational and comparative study of quality of life, anxiety, and depression. BMC Womens Health. 2024;24(1):251 DOI: https://doi.org/10.1186/s12905-024-03080-5

22. Evans MB, Decherney AH. Fertility and endometriosis. Clin Obstet Gynecol. 2017;60(3):497-502 DOI: https://doi.org/10.1097/GRF.0000000000000295

23. Van Barneveld E, Manders J, Van Osch FHM, Van Poll M, Visser L, Van Hanegem N, et al. Depression, anxiety, and correlating factors in endometriosis: a systematic review and meta-analysis. J Womens Health (Larchmt). 2022;31(2):219-230 DOI: https://doi.org/10.1089/jwh.2021.0021

24. Snyder H. Literature review as a research methodology: an overview and guidelines. J Bus Res. 2019;104:333-339 DOI: https://doi.org/10.1016/j.jbusres.2019.07.039

25. Pereira AS, et al. Metodologia da pesquisa científica. Santa Maria (RS): UFSM; 2018.

26. Crossetti MGO. Revisão integrativa de pesquisa na enfermagem: o rigor científico que lhe é exigido. Rev Gaucha Enferm. 2012;33(2):8-9.

27. Maulitz L, Stickeler E, Stickel S, Habel U, Tchaikovski SN, Chechko N. Endometriosis, psychiatric comorbidities and neuroimaging: estimating the odds of an endometriosis brain. Front Neuroendocrinol. 2022;65:100988 DOI: https://doi.org/10.1016/j.yfrne.2022.100988

28. Olliges E, Bobinger A, Weber A, Hoffmann V, Schmitz T, Popovici RM, et al. The physical, psychological and social day-to-day experience of women living with endometriosis compared with healthy age-matched controls: a mixed-methods study. Front Glob Womens Health. 2021;2:767114 DOI: https://doi.org/10.3389/fgwh.2021.767114

29. Nassiri Kigloo H, Itani R, Montreuil T, Feferkorn I, Raina J, Tulandi T, et al. Endometriosis, chronic pain, anxiety and depression: a retrospective study among 12 million women. J Affect Disord. 2024;346:260-265 DOI: https://doi.org/10.1016/j.jad.2023.11.034

30. Rempert AN, Rempert TH, Liu A, Hernández A, Blanck J, Segars J, et al. A systematic review of the psychosocial impact of endometriosis before and after treatment. Reprod Sci. 2024;31(7):1828-1860 DOI: https://doi.org/10.1007/s43032-024-01515-w

31. Khashchenko EP, Uvarova EV, Chuprynin VD, Pustynnikova MY, Fatkhudinov TK, Elchaninov AV, et al. Pelvic pain, mental health and quality of life in adolescents with endometriosis after surgery and dienogest treatment. J Clin Med. 2023;12(6):2400 DOI: https://doi.org/10.3390/jcm12062400

32. Wahl KJ, Imtiaz S, Lisonek M, Joseph KS, Smith KB, Yong PJ, et al. Dyspareunia in their own words: a qualitative description of endometriosis-associated sexual pain. Sex Med. 2021;9(1):100274 DOI: https://doi.org/10.1016/j.esxm.2020.10.002

33. Sarvestani MH, Noroozi M, Hashemi M, et al. A comprehensive interventional program to improve sexual function of women with endometriosis: a mixed-methods protocol study. Reprod Health. 2024;21:29 DOI: https://doi.org/10.1186/s12978-024-01759-4

34. Facchin F, Buggio L, Vercellini P, Frassineti A, Beltrami S, Saita E. Quality of intimate relationships, dyadic coping and psychological health in women with endometriosis: results from an online survey. J Psychosom Res. 2021;146:110502 DOI: https://doi.org/10.1016/j.jpsychores.2021.110502

35. Jaeger M, Niederkrotenthaler T, Till B, Werneck H. Associations between health-related quality of life, infertility-related psychological well-being and relationship quality in individuals with endometriosis: a cross-sectional study. BMC Womens Health. 2024;24(1):657 DOI: https://doi.org/10.1186/s12905-024-03510-4

36. Maulenkul T, Kuandyk A, Makhadiyeva D, Dautova A, Terzic M, Oshibayeva A, et al. Understanding the impact of endometriosis on women's life: an integrative review of systematic reviews. BMC Womens Health. 2024;24(1):524 DOI: https://doi.org/10.1186/s12905-024-03369-5

37. Schick M, Germeyer A, Böttcher B, Hecht S, Geiser M, Rösner S, et al. Partners matter: the psychosocial well-being of couples when dealing with endometriosis. Health Qual Life Outcomes. 2022;20(1):86 DOI: https://doi.org/10.1186/s12955-022-01991-1

38. Pereira MG, Ribeiro I, Ferreira H, Osório F, Nogueira-Silva C, Almeida AC. Psychological morbidity in endometriosis: a couple's study. Int J Environ Res Public Health. 2021;18(20):10598 DOI: https://doi.org/10.3390/ijerph182010598

39. Schreurs AMF, Dancet EAF, Apers S, Kuchenbecker WKH, van de Ven PM, Maas JWM, et al. The relation between patient-centered care and quality of life in women with endometriosis. Gynecol Obstet Invest. 2023;88(4):249-256 DOI: https://doi.org/10.1159/000531063

40. Grundström H, Engman L, Rimhagen E, Söderstierna C, Flink I. Experiences of communication in women with endometriosis: perceived validation and invalidation in different contexts and associations with health-related quality of life. J Psychosom Obstet Gynaecol. 2023;44(1):2264483 DOI: https://doi.org/10.1080/0167482X.2023.2264483

41. Chandel PK, Maurya PK, Hussain S, Vashistha D, Sharma S. Endometriosis and depression: a double agony for women. Ann Neurosci. 2023;30(3):205-209 DOI: https://doi.org/10.1177/09727531231152022

42. Zippl AL, Reiser E, Seeber B. Endometriosis and mental health disorders: identification and treatment as part of a multimodal approach. Fertil Steril. 2024;121(3):370-378 DOI: https://doi.org/10.1016/j.fertnstert.2023.12.033

43. Aerts L, Grangier L, Streuli I, Dällenbach P, Marci R, Wenger JM, et al. Psychosocial impact of endometriosis: from co-morbidity to intervention. Best Pract Res Clin Obstet Gynaecol. 2018;50:2-10 DOI: https://doi.org/10.1016/j.bpobgyn.2018.01.008

44. 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: https://doi.org/10.2147/IJWH.S119729

45. Mostafa J, Volodarsky-Perel A, Altshuler H, Doron A, Burke YZ, Elizur SE, et al. The impact of war situations on endometriosis patients: evaluating physical and mental health outcomes. J Health Psychol. 2024 DOI: https://doi.org/10.1177/13591053241288963

46. Donatti L, Malvezzi H, Azevedo BC, Baracat EC, Podgaec S. Cognitive behavioral therapy in endometriosis: psychological-based intervention. Rev Bras Ginecol Obstet. 2022;44(3):295-303 DOI: https://doi.org/10.1055/s-0042-1742406

47. Rodrigues LA, Almeida SA, Ferreira GN, Nunes EFC, Ávila PES. Análise da influência da endometriose na qualidade de vida. Fisioter Mov. 2022;35:e35124 DOI: https://doi.org/10.1590/fm.2022.351240

Cómo citar

Helena de Souza Coelho, L., Gomes Junqueira, M. C. ., & Alves, L. J. (2026). IMPACTO PSICOSOCIAL DE LA ENDOMETRIOSIS: REVISIÓN SOBRE DOLOR CRÓNICO, SEXUALIDAD, INFERTILIDAD Y RELACIONES. RECIMA21 - Revista Científica Multidisciplinar - ISSN 2675-6218, 7(4), e747569. https://doi.org/10.47820/recima21.v7i4.7569