Cognitive behavioural therapy helps women with endo pain, study shows

The recent study looked at how much endometriosis pain interfered with a person’s quality of life and if CBT could help. After participants did 8 weeks of CBT, the researchers saw a 22% drop in pain impacting life. Around 40% of the participants also reported an improvement in their condition.

Endometriosis is a long-term condition where tissue, similar to the lining of the uterus, grows in other parts of your body.

CBT is a form of psychological therapy. It involves you working with a therapist to understand how your thoughts, feelings, physical symptoms and behaviours connect.

More than 300 people with endometriosis-related pain took part in the study, led by Deakin University, with support from Jean Hailes for Women’s Health.

A therapist ran the sessions in groups online and the CBT was endometriosis-focused to ensure the language and examples used were appropriate and relevant.

Associate Professor Subhadra Evans, a chief investigator of the study, says the research was about offering more support to people navigating this complex condition.

“Endometriosis has been a very long-neglected field … and the treatments have been very limited up to this point,” she says.

“Where we’ve come from with this research is how do we support people’s wellbeing living with this very challenging condition?

“Options and choice – it’s so important.”

After surgery, CBT made Kat’s life easier

For Kat Stanley, endometriosis “completely derailed” her life for about 20 years.

The provisional psychologist and pelvic pain advocate recalls how growing up she missed large chunks of school and made multiple visits to hospital in horrendous pain.

“I got fobbed off and told that it was all in my head.”

When her endometriosis diagnosis eventually came decades later, she got huge relief through surgery. It helped with her heavy periods, but the pain didn’t go away.

Eventually, with the help of a therapist, she tried CBT.

“It totally changed my experience of pain,” she says.

“I had to work pretty hard to discover what my automatic thoughts were. It’s very natural when you’re in pain to stop and not want to do anything. CBT kind of helped me identify which of those behaviours and thoughts were helping me and which weren’t and replace the unhelpful thoughts with more adaptive thoughts.

“It’s made it way easier to live with pain.”

Kat helped develop the endometriosis CBT sessions in the recent study. “I oversaw the language used in the sessions to make sure it was appropriate for people with lived experience.”

What’s next?

Associate Professor Evans hopes to one day see an endometriosis-specific CBT program rolled out and freely available to everyone with endometriosis in Australia.

“That’s our dream,” she says. But she adds more research is needed to understand if and how CBT can benefit more people with the condition, including those with other endometriosis symptoms, like fatigue.

“We’re just at the very beginning of this research.”

Ideally, she says, CBT will add to – not replace – other treatments for endometriosis.

“This is a whole person disease … so we need lots of different treatments to support people,” she says.

Gynaecologist, Associate Professor Pav Nanayakkara agrees: “The most effective care is multi-faceted, combining medical and surgical treatments with pain education, psychological support and lifestyle strategies.”

Associate Professor Nanayakkara, who specialises in endometriosis care and works through the Jean Hailes Clinic, adds: “CBT … has potential as an additional tool to help manage pain, reduce distress and improve quality of life, especially as we push for more research and better treatment options.”

Read more about endometriosis treatment options.