By Marc Dellière, Medical Consultant & Trainer – Specialist in Stress, Prevention & Integrative Health
Endometriosis is typically presented as an estrogen-dependent condition. This is true.
But is this interpretation complete?
In practice, many patients describe more intense pain during periods of stress, disturbed sleep, persistent fatigue, and increased hypersensitivity.
This observation is probably not anecdotal.
The role of biological stress
Chronic stress activates the hypothalamic-pituitary-adrenal axis. Cortisol increases and communication with the gonadal axis changes.
Inflammation and pain amplification
At the same time, the body becomes more inflammatory. Neuroinflammation progresses, which means that the nervous system enters a state of sustained alertness that amplifies the perception of pain. Certain immune cells, such as mast cells, become activated. These cells participate in inflammatory reactions and release mediators that maintain local inflammation. The nervous system then becomes more reactive, a phenomenon called central sensitization, where normally tolerable signals are perceived as more painful.
Simultaneously, deep sleep becomes more fragile, even though it plays an essential role in regulating cortisol and inflammatory processes.
An amplification loop
Stress does not cause the lesion. But it can amplify its expression. A consistent cycle then sets in. Stress, inflammation, pain, then stress again.
If endometriosis is hormonal, the body functions as an integrated system.
In situations of prolonged alertness, fine regulatory mechanisms, particularly neuroendocrine ones, become more unstable.
Towards a more systemic approach
This opens up strategic considerations for healthcare professionals. Purely hormonal approaches sometimes show their limitations in terms of tolerance, compliance, and overall vision.
Integrating biological stress regulation could be an additional lever.
Bioactive peptides such as Lactium® are part of this modulation approach, interacting with GABA-A receptors, attenuating the stress response in certain studies, and improving sleep.
It is not a question of treating endometriosis. It is a question of reducing a cross-cutting amplifier.
Perhaps the question is evolving. Beyond hormonal control, how can the system be calmed?
Learn more about Lactium® for stress management!
Scientific sources :
Brasil DL, Montagna E, Trevisan CM, et al. Psychological stress levels in women with endometriosis: systematic review and meta-analysis. Arch Gynecol Obstet. 2020;302(3):527-537.
https://pubmed.ncbi.nlm.nih.gov/31755674/
Appleyard CB. The link between stress and endometriosis: from animal to human evidence. Reprod Sci. 2020;27(6):1226-1237.
https://pubmed.ncbi.nlm.nih.gov/32542543/
Laganà AS, et al. Stress, pain, anxiety and depression in endometriosis: pathophysiological and clinical implications. Int J Mol Sci. 2024;25.
https://pubmed.ncbi.nlm.nih.gov/38565045/