Abordagem Psicológica Na Endometriose: Experiência De Dor E Melhora Na Qualidade De Vida Das Mulheres

Abstract

Endometriosis is a chronic condition affecting 10 to15% of women in childbearing age. Understanding the impact of this disease on women's well-being is still a challenge, namely to intervene. Pain is the most current and troublesome symptom. Although medical treatments for pain relief are effective, recurrence rate remains significant, calling for a better understanding and development of new approaches for pain management. A group Cognitive Behavioral Therapy (CBT) for management of associated co-morbidities is suggested, paying special attention to Chronic Pelvic Pain (CPP). CBT design can be grounded on information collected from focus groups and a one-group exploratory trial. Evaluation of therapy effectiveness is possible to be performed by comparing group CBT to Usual Care (UC) and Support Group (SG) in a randomized controlled trial. Research in this area could represent an important step in providing a solution to the management of endometriosis and, to the best of our knowledge, the first national psychological approach for its understanding and treatment. Keywords-endometriosis, women's experience, chronic pelvic pain, cognitive behavioral therapy ABORDAGEM PSICOLÓGICA NA ENDOMETRIOSE: EXPERIÊNCIA DE DOR E MELHORA NA QUALIDADE DE VIDA DAS MULHERES RESUMO: A endometriose é uma doença crónica que afecta 10 a 15% das mulheres em idade reprodutiva. O entendimento do impacto da doença no bem-estar estar das mulheres continua a ser um desafio, nomeadamente para a intervenção. A dor é o sintoma mais frequente e preocupante. Apesar dos tratamentos para alívio da dor serem eficazes, a taxa de recorrência é significativa, apelando à necessidade de melhor conhecer a doença e desenvolver novas abordagens para gestão da dor que lhe está associada. Sugere-se uma terapia Cognitivo Comportamental (CBT) de grupo para gestão das comorbilidades associadas, com especial foco na Dor Pélvica Crónica (CPP). O design da CBT baseia-se em informação recolhida de focus groups e um ensaio exploratório de um grupo. A avaliação da CBT será realizada através de um ensaio clínico randomizado, comparando a terapia com o Tratamento Usual (UC) e Grupo de Apoio (SG). A investigação nesta área poderá representar um passo importante no desenvolvimento de uma solução para gestão da endometriose, e de acordo com o nosso entendimento, a primeira abordagem psicológica nacional para o seu estudo e tratamento. Palavras-chave-endometriose, experiência das mulheres, dor pélvica crónica, terapia cognitivo comportamental

Pain‐focused psychological interventions in women with endometriosis: A systematic review

“…It is noteworthy that EMS is most commonly observed among women in their 30-40s, and may make it harder to get pregnant, i.e., the most prevalent age is between 35 and 44. 6,7 The symptoms of this condition are abundant, including pain and chronic pelvic pain, painful intercourse (viz., dyspareunia), menstrual cramps (or dysmenorrhea), fertility decline, constipation, diarrhea, anxiety, mood swings, and depression 5,[8][9][10] Besides, EMS is often associated with pain, particularly chronic pelvic ones, affecting different aspects of women's lives, 11,12 and leading to negative impacts on their abilities in terms of performing their own daily activities, taking on maternal roles, fulfilling their marital relationships, and losing jobs. 9,10 EMS can further have biopsychosocial effects, giving rise to psychosomatic disorders.…”

“…As a painful, chronic inflammatory disease, endometriosis (EMS) is characterized by the proliferation of endometrial glands and stroma outside the uterine cavity. [1][2][3] The prevalence rate of this health condition has been also reported by 10%-15% 1,4,5 and its incidence rate has been estimated as 8-12 individuals per 1000 population. It is noteworthy that EMS is most commonly observed among women in their 30-40s, and may make it harder to get pregnant, i.e., the most prevalent age is between 35 and 44.…”