Endometriosis Linked to Persistent Rise in Mental Health Medication Use

Women who were later diagnosed with endometriosis filled more prescriptions for antidepressants and anxiolytics—and had more psychiatric hospital contacts for depression or anxiety—than women without the disease, with the gap emerging as early as 10 years before diagnosis and widening afterward, according to a large registry-based study published in Human Reproduction.¹

Excess Medication Use Predates Diagnosis by a Decade

The study followed 136,842 Danish women aged 15 to 55 years between 2000 and 2019, matching 22,807 women with a first-time hospital-based endometriosis diagnosis to 5 women without the diagnosis for each case (n = 114,035).¹ Using national registry data on filkled prescriptions and psychiatric hospital contacts, investigators applied negative binomial regression to compare patterns for up to 10 years before and 10 years after each woman's index diagnosis date.

Adjusted incidence rate ratios (IRRs) for antidepressant use were 1.29 (95% CI, 1.23-1.36) in the decade before diagnosis and 1.40 (95% CI, 1.34-1.47) in the decade after. For anxiolytics, IRRs rose from 1.16 (95% CI, 1.05-1.28) before diagnosis to 1.46 (95% CI, 1.29-1.64) after. Psychiatric hospital contacts for depression or anxiety followed a similar pattern, with IRRs of 1.28 (95% CI, 1.09-1.49) before diagnosis and 1.41 (95% CI, 1.22-1.63) after. Women with endometriosis redeemed 29% more antidepressant prescriptions and 16% more anxiolytic prescriptions than women without the disease in the years before diagnosis; those gaps widened to 40% and 46%, respectively, after diagnosis.²

"What surprised us was how clear and persistent the pattern was, and that the difference did not diminish over time," said Marie Josiasen, PhD candidate at Aarhus University's Department of Public Health and one of the study's authors, in a statement.² "On the contrary, women with endometriosis consistently redeemed more prescriptions for antidepressant medication than women without the disease throughout the entire period, from 10 years before to 10 years after diagnosis."

A Diagnosis Does Not Ease the Burden

Josiasen said the psychological strain did not resolve once women received a diagnosis and, in some respects, grew worse.

"A diagnosis can be a relief, but it also involves coming to terms with having a chronic illness," she said.

The study authors pointed to several possible explanations, including prolonged pain, uncertainty about the cause of symptoms, and frustration over disrupted quality of life; for some women, infertility may add to the psychological burden.

The findings extend a body of literature already linking endometriosis to elevated depression and anxiety; a 2025 systematic review and meta-analysis of 9 studies found a pooled relative risk of 2.82 for anxiety and 2.93 for depression among women with endometriosis compared with those without the condition.³ What the Danish registry data add is a long, prediagnostic window, showing the excess burden is measurable a decade before diagnosis, not only afterward.¹

The authors cautioned that their results apply only to hospital-based endometriosis diagnoses; women managed solely in general practice or by private gynecologists were not captured, and not all women with depression or anxiety receive medication or hospital-based care.¹ They said future research should investigate the causal pathways connecting endometriosis to depression and anxiety.

References

1. Josiasen M, Melgaard A, Bech BH, Hansen KE, Rytter D. Endometriosis and the mental health burden: a registry-based study of redeemed prescriptions and psychiatric hospital contacts before and after diagnosis of endometriosis. Hum Reprod. 2026;41(8):1338-1349. doi:10.1093/humrep/deag089
2. Widespread women's disease takes a mental toll—before and after diagnosis. News release. Aarhus University. August 19, 2026. Accessed September 17, 2026. https://www.eurekalert.org/news-releases/1140694
3. Ye Q, Feng H, Ye Q. Relationship between endometriosis and mental health: a systematic review and meta-analysis. Arch Med Sci. 2025;21(5):1985-1996. doi:10.5114/aoms/208502