The surprising link between endometriosis and compassion

What is endometriosis?

Around 190 million women worldwide suffer from endometriosis. The mind boggles at a number this high, but endometriosis affects about 10% of women of reproductive age, according to the WHO.

The condition is characterised by severe pain due to tissue similar to the endometrial lining occurring in other parts of the body and a large number of co-morbid physical and emotional symptoms.

Women suffering from endometriosis often have fertility difficulties and issues with sexual intimacy due to pain; they are frequently affected by other conditions like fibromyalgia, migraines or vulvodynia and can suffer high levels of stress, shame and depression due to the impact their symptoms have on their lives.

Considering how impactful endometriosis can be, many women still suffer for years without receiving the correct diagnosis, due to their pain often being dismissed as “normal period pain” and a general misunderstanding of the condition.

The profound impact of endometriosis

It is not difficult to imagine how devastating it might be to experience severe pain for years and to have this pain dismissed by the medical professionals you are asking for help. In the UK, most women will wait an average of more than 8 years for a diagnosis, at which point they will have spent almost a decade in pain that no one seems to be able to or willing to explain and alleviate.

A new study by Facchin et al. (2025) has shown that, unsurprisingly, women suffering from endometriosis are particularly vulnerable to very self-critical thinking. The researchers showed that women suffering from endometriosis will often blame themselves for their condition - unsurprisingly, given that many women may have been told their pain is “all in their head” for years.

While it is true that women with endometriosis and other pain conditions can fall victim to a vicious cycle in which stress and trauma affect pain sensitivity and vice versa, this does not mean that their pain experience is any less real. In fact, evidence suggests that stress and trauma have an effect on the body's immune system and, through inflammatory responses, can exacerbate pain significantly.

The chronic stress from having to manage an unpredictable pain condition can lead to pain catastrophising, feeling out of control and alone, further exacerbating the pain and stress characteristic of the disease.

Beatrice’s story: A case study in self-criticism and pain

When Beatrice first came to see me, she had already been through several attempts at therapy to deal with chronic pain. She had only recently received a diagnosis of endometriosis and was struggling with coming to terms with what this meant for her.

It had taken her 6 years of back-and-forth visits to her GP, invasive tests and surgery to receive an explanation for the debilitating pain she had been dealing with every month, and now she felt more vulnerable than ever.

Her pain had kept her off work and made her feel, in her own words, “abnormal”, “unbelievably alone”, and “like a complete failure”. The diagnosis finally put a label on something she had been dealing with for years, and it validated her experience. It told her that her symptoms were not in her head. But the trauma from years of feeling alone and not believed had ground down her psyche and left her grieving and angry.

Beatrice had always had difficulty with self-confidence, but the chronic pain she experienced from her endometriosis made her negative self-talk spiral. She convinced herself she was somehow at fault for her pain and started to isolate herself from her friends and family, when repeated disappointing doctor visits and treatments made her and those around her feel helpless and hopeless in the face of her suffering.

What Beatrice lacked more than anything was the self-compassion that might have helped her interpret her symptoms in a less shaming way. Beatrice eventually was able to identify her negative self-talk as an outcome of her trauma - the trauma of feeling dismissed, abandoned and alone for years. She learned strategies to build up a more compassionate voice, one that told her that what she had been through was incredibly difficult and traumatising and that she deserved care and kindness from herself and others.

How self-compassion can support well-being

So how can we help those with endometriosis, and how can you help yourself to break this loop, this downward spiral?

The latest evidence suggests that working on compassion can have a significant impact on women's pain experience in endometriosis. While the study by Facchin et al. (2025) did not show a decrease in pain in those suffering from endometriosis, they showed that self-compassion was connected to higher levels of emotional well-being, suggesting that a significant reason for women's emotional suffering in endometriosis is feeling alone, punished, and at fault.

If you, or someone you know, is suffering from endometriosis and is dealing with depression and anxiety in the context of the condition, know that there is support available that can help.

Self-compassion skills can take many different forms and are something that a mental health professional can work on with you. Treatment might focus on addressing your inner critic, strengthening your support system or specific exercises like compassionate letter writing, compassionate imagery or mindfulness.

Addressing negative thought spirals in endometriosis can have an impact on your stress response, which can ultimately impact how manageable the condition might feel. And always know that you are not alone, and there are others who understand what you are going through.  

References

Appleyard, C. B., Flores, I., & Torres-Reverón, A. (2020). The link between stress and endometriosis: from animal models to the clinical scenario. Reproductive Sciences, 27(9), 1675-1686. 

Devlin, H. (2024, February 28). Women in UK waiting almost nine years for endometriosis diagnosis, study finds. The Guardian. 

Facchin, F., Grosso, F., Saita, E., Vercellini, P., & Pagnini, F. (2025). Can self-compassion and mindfulness predict psychological wellbeing in individuals with endometriosis? Findings from an online survey. BMC Women’s Health, 25(1), 310.

World Health Organization. (2025, October 15). Endometriosis.