Psychological therapy can help provide better quality of life for women with endometriosis

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Nearly 10% of Danish women suffer from endometriosis, which can cause serious pelvic pain. A new study from Aarhus University shows that women who undergo both medical treatment and a course of psychological therapy experience fewer symptoms and have a better quality of life.

Severe abdominal pain, constipation and extremely painful periods: that is the reality for the around 5-10% of Danish women who suffer from endometriosis. Endometriosis is due to tissue resembling the uterine mucosa becoming lodged outside the uterus in the abdominal cavity, where it bleeds and causes a chronic inflammatory condition, and can lead to adhesions between the organs. For some women, the symptoms are so serious that they have a huge impact on their everyday lives and quality of life. A new study from Aarhus University now shows that women can benefit greatly from supplementing their medical treatment with a course of psychological therapy specifically targeted at endometriosis patients. So says the researcher behind the study, Karina Ejgaard Hansen, clinical psychologist and postdoc at the Department of Public Health:

"We can see that a ten-week course of psychological group therapy can significantly increase quality of life for these women. That means that although it is not possible to do more to relieve the pain, we can still do something to help these women and improve their quality of life."

The study also shows that mindfulness and acceptance-based psychological intervention work just as well as non-specific psychological therapy, says Karina Ejgaard Hansen.

"It's interesting that it is not a question of a specific method of psychological therapy, but that women find their quality of life is improved by both forms of psychological intervention. This offers more and better possibilities to help them."

According to Karina Ejgaard Hansen, this is the first study to establish that psychological therapy makes a difference.

The study is the first which, in a well-controlled, randomized trial, has compared three different groups in order to study the effect of psychological therapy for women with endometriosis and chronic pelvic pain. That is why it is only now that we can conclude with reasonable certainty that the effects are due to the psychological treatment, and not just because we are 'doing something', or that it is an effect that would have occurred over time anyway."

Karina Ejgaard Hansen, clinical psychologist

Less helplessness and fewer symptoms

The women in the trial did not experience reduced pain after the psychological therapy, but they found they were able to handle it better, and other symptoms were also reduced, says Karina Ejgaard Hansen.

"The women felt less helpless and found that they had better control over the disease and their own psychological well-being. In fact, they found that symptoms such as constipation and pain during defecation were also reduced."

The trial thus also represents a possible breakthrough in the treatment that these women can be offered in Denmark, says Karina Ejgaard Hansen.

"Today, psychological therapy or support is not part of the public sector treatment offered to women who suffer from endometriosis. However, this study shows that women with chronic pain would benefit from being provided with more interdisciplinary treatment options in future."

The study goes digital

As part of a major EU-funded research project (EU Horizon 2020: FEMaLe – Finding Endometriosis using Machine Learning), the treatment process is currently being digitised. The aim is to reach out to women all over the country online.

The effects of the digital/online treatment programme, with a focus on quality of life, work capacity and the physical and mental health of women with endometriosis, will subsequently be examined in a more extensive study.

Digital/online psychological treatment or support is not currently part of the public sector treatment offered to women who suffer from endometriosis, either.

Source:
Journal reference:

Hansen, K. E., et al. (2023). Psychological interventions improve quality of life despite persistent pain in endometriosis: results of a 3-armed randomized controlled trial. Quality of Life Research. doi.org/10.1007/s11136-023-03346-9

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