Physical therapy and psychological intervention normalize cortisol levels and improve vitality in women with endometriosis

Abstract

There is as yet no effective treatment for endometriosis. The objective of this study was to evaluate the effectiveness of submitting women with endometriosis and chronic pelvic pain to a therapeutic protocol involving physical and psychological therapy. Twenty-six female volunteers were submitted to a treatment protocol consisting of 2.5-h sessions, once a week for 10 weeks. We applied a Visual Analogue Scale, the Perceived Stress Questionnaire (PSQ), and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Morning, afternoon, and evening levels of cortisol were determined in saliva samples. The PSQ scores were significantly lower after treatment, whereas the scores for the SF-36 vitality and physical functioning domains were significantly higher. Salivary cortisol levels were higher after treatment in the samples collected in the morning, but not in those collected in the afternoon or evening. The post-treatment cortisol levels were similar to those reported for healthy women. There were positive correlations between vitality, role emotional, social functioning, and mental health, and negative correlations to perceived stress. In conclusion, the physical and psychological intervention protocol applied in this study to women suffering of endometriosis was effective in reducing perceived stress, normalizing cortisol levels, increasing vitality and improving physical functioning.

When treating the pain is not enough: a multidisciplinary approach for chronic pelvic pain

“…Unfortunately, there is limited research citing effective psychological interventions for CPP populations; however, research conducted with other forms of chronic pain may provide insight into effective psychological interventions for CPP patients. For example, targeted psychological interventions, such as psychotherapy and motivational interviewing, for other forms of chronic pain have improved depression, anxiety, physical functioning, and sometimes also pain ratings (Kames et al 1990;Peters et al 1991;Friggi Sebe Petrelluzzi et al 2012;Miller et al 2013). Future research should evaluate whether these types of psychological interventions have the same positive impact with CPP patients.…”

Patients with endometriosis using positive coping strategies have less depression, stress and pelvic pain

“…The diagnosis and experience with the disease can involve a number of spheres in a woman’s life, such as, physical, 3-5 emotional, 6,7 marital, sexual, 8,9 professional 10,11 and psychological. 3-5,12-14 …”

Stress Management Affects Outcomes in the Pathophysiology of an Endometriosis Model

“…11,12 Although limited, there is some evidence that psychological interventions can downregulate stress and increase measures of quality of life in patients with endometriosis. 13 We propose to expand this knowledge by dissecting the mechanisms that underlie the possible beneficial effects of stress management interventions using an animal model of endometriosis. Our main goal is to support the development of psychological, behavioral, and stress management interventions as part of a multidisciplinary preventive and clinical management for patients with this painful condition.…”