For Employers & Payers
Many people with endometriosis in Visana's program talk about how their mental health has been affected by living with chronic pain. As if having a stigmatized menstrual pain condition wasn't enough; many women with endometriosis also suffer from stigmatized mental health issues. This does NOT mean that the pain is all in your head!
On the contrary, it means that living with chronic pain has far-reaching effects on your life, and chronic pain actually directly leads to mental health issues. This should seem obvious to anyone who lives with chronic pain: when you're having a particularly bad flare, it's easy to resign and just want to "give up" for the day and stay in bed.
This number might come across as staggering, but a massive number of women with endometriosis do indeed suffer from mental health issues.  When we talk with women with endo and state this statistic, we tend to get the same response time and time again.... "That makes sense." People who live with chronic pain understand the massive impact it has on living your daily life.
Endo touches so many parts of your life, and the condition causes mental stress in many different. People with endo have to deal with the impact endo has on romantic and intimate relationships, the fertility impact of endometriosis, the productivity impact endo has in school and at work, the uncertainty of ever getting a diagnosis, and the emotional impact of cycling through drugs that have side effects. 
It's important to know that, if you have endo and are suffering from mental health issues, you aren't alone. Sadly, this is normal, and mental health issues are hugely under-treated in endometriosis patients. Many healthcare professionals don't know to properly treat the "psychosocial" impacts of chronic diseases. In fact, in a recent survey, 72% of OBGYNs stated they don't feel adequately trained to provide care for the mental health component of endometriosis. 
Research has shown that chronic pain conditions, including endometriosis, can lead to mental health issues through a "vicious cycle" as illustrated below.  You're probably familiar with the emotions that stem from chronic pain: the anger, the fear, and the distress. When these feelings go on for decades, as they often do with endometriosis, they can lead to depression & anxiety and an increased pain perception.
This research clearly demonstrates that, while the pain is NOT all in your head, the mental health component of endo can actually worsen your pain. That's why it's important to pursue a "whole person" approach that includes not only gynecological care, but also treatments aimed at alleviating any mental health issues that have been caused by living with chronic pain.
This is exactly why Visana has integrated cognitive behavioral therapy (CBT) concepts into our program. We want to democratize access to resources that can assist with improving mental health.
How has endometriosis affected your mental health? Shoot us an email at firstname.lastname@example.org if you'd like to share your story.
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 Sepulcri Rde P, do Amaral VF. Depressive symptoms, anxiety, and quality of life in women with pelvic endometriosis. Eur J Obstet Gynecol Reprod Biol. 2009;142(1):53–56.
 The social and psychological impact of endometriosis on women's lives: A critical narrative review, Culley et. al, Human Reproduction Update 2013
 Patterns in the Management of Endometriosis Among Physicians: A Cross-Sectional Survey, Srinidhi et. al, Obstetrics and Gynecology 2000
 Comorbidity of Chronic Pain and Mental Health Disorders: The Biopsychosocial Perspective, Gatchel, Robert J. American Psychologist 2004