Psychoimmune Interactions in Women of Reproductive Age with Endometriosis

Abstract

Psychoimmune interactions were studied in women of reproductive age with endometriosis. Pronounced immunological shifts manifested in a shift of the T-cellular immunity, resulting in imbalanced production of pro- (IL-1β, IL-2, IFN-γ) and anti-inflammatory (IL-4) cytokines. Significant correlations between the severity of mental shifts and immunopathogenetic factors in the studied patient population demonstrated the psychoneuroimmune nature of endometriosis.

A Systematic Review of the Association Between Psychiatric Disturbances and Endometriosis

“…1 Depression and anxiety are common comorbid conditions that are reported in some research to be associated with endometriosis. 17 In women with endometriosis, depression and anxiety have been found to co-occur and positively correlate (r = 0.41, P < 0.001) with each other, 33 although it is not unusual for anxiety and depression to co-occur together in cohorts of women without endometriosis. 34 Sepulcri and Amaral found that in a sample of 104 women with a diagnosis of pelvic endometriosis, 64.4% endorsed moderate-to-severe depressive symptom levels and 63.5% reported high levels of anxiety symptoms.…”

“…Thus, it has been recommended by several authorities that if hormonal medical management alone fails in women with endometriosis, then medication used for management of inflammation and neuropathic pain, such as amitriptyline or gabapentin, should be considered. 4,13,33,46 Chronic pelvic pain has been found to be associated with negative psychological, physical, and social consequences, including mood swings and moderate-to-severe levels of depression and anxiety. These associated issues may be a consequence of the long delay between the onset of symptoms and the diagnosis of endometriosis, which was reported by Arruda et al to range between 3.5 and 12 years, with longer delays occurring for women who are younger at symptom onset.…”

“Free butterflies will come out of these deep wounds”: A grounded theory of how endometriosis affects women’s psychological health

“…Endometriosis is also an inflammatory disease because the presence of endometrial tissue outside the uterine cavity causes an inflammatory response (Luisi et al, 2015). Several studies have demonstrated that inflammatory diseases such as endometriosis may be associated with mood disorders due to the interaction between the immune system and the neural central system (Nasyrova et al, 2011). Qualitative research has described the negative impact of the disease and pelvic pain on several dimensions, such as everyday activities, social and work functioning, family and intimate relationships, plans for the future (including having children), and psychological well-being (Denny, 2009; Roomaney and Kagee, 2015, 2016).…”

Medical and surgical interventions to improve the quality of life for endometriosis patients: a systematic review

“…Associations between immunopathogenetic factors (imbalanced production of pro-and anti-inflammatory cytokines) and severe shifts in mood and mental health have been established in patients with endometriosis. Peripheral immunological alterations may induce the central neural system to cause a response that includes behavioral changes (such as fatigue, anhedonia, or sadness), which may negatively affect social interactions and relationships [85]. Furthermore, women with chronic pelvic pain related to endometriosis have pain hypersensitivity due to central and peripheral sensitization.…”