Self-management and psychological-sexological interventions in patients with endometriosis: strategies, outcomes, and integration into clinical care

Abstract

Endometriosis has a multifactorial etiology. The onset and progression of the disease are believed to be related to different pathogenic mechanisms. Among them, the environment and lifestyle may play significant roles. Diet, dietary supplements, physical exercise, osteopathy, massage, acupuncture, transcutaneous electrical nerve stimulation, and Chinese herbal medicine may represent a complementary and feasible approach in the treatment of symptoms related to the disease. In this narrative review, we aimed to examine the most updated evidence on these alternative approaches implicated in the self-management of the disease. In addition, several studies have demonstrated that endometriosis may negatively impact mental health and quality of life, suggesting that affected women may have an increased risk of developing psychological suffering as well as sexual problems due to the presence of pain. In light of these findings, we discuss the importance of integrating psychological interventions (including psychotherapy) and sexual therapy in endometriosis treatment.

Systematic review and meta‐analysis of complementary treatments for women with symptomatic endometriosis

“…Recently, Buggio et al . described interventions for the self‐management of physical, psychologic, and sexual symptoms for women with endometriosis .…”

“…The other review evaluated physical exercise among women with endometriosis, but it included studies that were not randomized controlled trials (RCTs) and found that data were inconclusive on the benefits of exercise for improving pain symptoms. Buggio et al . present a view on psychologic and sexual aspects related to endometriosis, discussing several points leading to the self‐management of symptoms.…”

Endometriosis: Aspectos Psicologicos

“…(7) Manejo terapéutico En el caso de la endometriosis, el tratamiento más utilizado para mejorar sus síntomas es el hormonal. Sin embargo, se ha sugerido la utilización de medicina china basada en plantas, y medicina alternativa; así como apoyo psicológico y de sexología para abarcar de manera integral la sintomatología presentada por las mujeres que padecen la patología (26). Al respecto Zhao et al (27) investigaron el impacto de la relajación muscular progresiva sobre los niveles de ansiedad, Depresión y calidad de vida de los pacientes con endometriosis Sometidos a terapia de agonistas de GnRH.…”

Medical treatment of endometriosis: an update

“…41,42 Complementary and alternative medicine (CAM) has been used extensively in most Asian countries since the nineteenth century; however, their utilization in Western countries has been rapidly growing. 43,44 As stated by the World Health Organization, CAM comprises a range of different health-related strategies that can be defined as predominantly operating outside the conventional medical curriculum and profession. 45 The list of CAMs includes several procedures and products that have been tested in the treatment of women with endometriosis, such as osteopathic manipulative therapy (OMT), massages, acupuncture, transcutaneous electrical nerve stimulation (TENS), CHM, vitamins, and dietary supplementations.…”

“…However, no definitive conclusions can be drawn from these studies, due to the small sample sizes. 44 TENS is a non-invasive and low-cost technique based on the use of mild electrical impulses applied to the intact surface of the skin with the objective of stimulating lowthreshold nerves to relieve pain and favor the release of endogenous opioids. TENS has been mentioned as alternative short-term pain management in women with dysmenorrhea in a consensus document on the management of endometriosis.…”