Selected Parameters of the Mental State of Women with Endometriosis—A Systematic Review

Background: Endometriosis is a chronic, estrogen-dependent inflammatory disorder affecting millions of women worldwide and constitutes a major cause of chronic pelvic pain and reduced quality of life. Increasing evidence suggests that the burden of the disease extends beyond physical symptoms and includes substantial psychological distress. This systematic review aimed to summarize current evidence regarding the association between endometriosis and mental health outcomes, including depression, anxiety, sleep disturbances, sexual dysfunction, and quality of life. Methods: A systematic literature search was conducted in PubMed, Europe PMC, and Google Scholar to identify studies published between 2015 and 2025 evaluating psychological outcomes in women diagnosed with endometriosis. Studies were screened according to predefined inclusion criteria and analyzed qualitatively. A total of 93 studies were included in the final review. Results: Women with endometriosis consistently demonstrated higher prevalence and severity of depressive symptoms and anxiety compared with control populations. Health-related quality of life was significantly reduced across studies. Chronic pelvic pain, particularly its intensity, persistence, and neuropathic-like characteristics, emerged as a key factor mediating the relationship between endometriosis and psychological distress. Additional contributors included sleep disturbances, fatigue, impaired sexual functioning, reduced self-esteem, and relationship difficulties. Emerging evidence also suggests that chronic inflammation, neuroimmune interactions, and gut–brain axis dysregulation may contribute to the coexistence of endometriosis and mood disorders. Conclusions: Endometriosis is associated with adverse mental health outcomes and reduced quality of life. These findings highlight the importance of multidisciplinary management strategies integrating pain control, psychological assessment, and psychosocial interventions to improve overall patient well-being.