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. 2025 May;311(5):1371-1377.
doi: 10.1007/s00404-024-07878-4. Epub 2024 Dec 27.

Predictors of anxiety in endometriosis patients

Tomas Kupec  1 , Lisa Wagels  2   3 , Rebecca Caspers  4 , Philipp Meyer-Wilmes  4 , Laila Najjari  4 , Elmar Stickeler  4 , Julia Wittenborn  4
Affiliations

Predictors of anxiety in endometriosis patients

Tomas Kupec et al. Arch Gynecol Obstet. 2025 May.

Abstract

Purpose: To evaluate the main factors influencing anxiety in endometriosis patients presenting to an endometriosis centre in Germany.

Methods: One hundred and eighty-two patients were asked to complete the German version of the STAI (state anxiety and trait anxiety) questionnaire prior to examination for diagnosis and treatment of pelvic pain or suspected endometriosis. Typical endometriosis symptoms, main complaints, operations, type of endometriosis and planned treatment were analyzed as influencing factors of anxiety in endometriosis patients. We performed linear multiple regression analyses using the forward stepwise method to test which characteristics associated with endometriosis symptoms were associated with trait anxiety and state anxiety.

Results: Analysis of the STAI results showed that higher levels of trait anxiety were found in patients with ovarian endometriosis: t (177) = 3.06, p = 0.003 and in patients with symptoms of dyspareunia: t (177) = 2.36, p < 0.020). On the other hand, patients with recurrent endometriosis showed lower levels of trait anxiety: t (177) = - 2.39, p = 0.018. Significantly higher levels of state anxiety were found in patients with persistent endometriosis: t (177) = - 2.45, p = 0.015 and in women with endometriosis who were indicated for surgical therapy: t (177) = 3.89, p < 0.001.

Conclusions: We were able to show that higher levels of ongoing anxiety in endometriosis patients are associated with dyspareunia and ovarian endometriosis, which may have a negative impact on partnership and desire to have children. On the other hand, patients with persistent endometriosis or a type of disease that requires surgery have higher levels of immediate situational anxiety.

Keywords: Anxiety; Endometriosis; Lower abdominal pain; STAI.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare that they have no conflict of interest. Ethical approval: Participation in the study was voluntary and all procedures were in accordance with the Helsinki Declaration (2013) and its subsequent amendments. The study was approved by the local ethics committee (EK 24-009).

Figures

Fig. 1
Fig. 1
Reason for the presentation of the patients to the Endometriosis Centre of the RWTH Aachen University Hospital
See this image and copyright information in PMC

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