Stress reactivity and family relationships in the development and treatment of endometriosis.

ABSTRACT

OBJECTIVE: To examine stress physiology and facts of family functioning associated with development and course of endometriosis symptoms. DESIGN: Clinical case data and literature review. SETTING: Private practice in hospital-affiliated medical office. PATIENT(S) One woman with endometriosis, her parents, and a nonsymptomatic volunteer. INTERVENTION(S) Measures of physiologic and neural reactivity with biofeedback and neurofeedback equipment during family history interview and while sitting quietly. MAIN OUTCOME MEASURE(S) Electroencephalography (EEG), digital skin temperature (DST), electrodermal response (EDR), and electromyography (EMG); facts of family history; contact with family. RESULT(S) Endometriosis symptoms were associated with DST, EDR, EMG, and EEG measures indicating prolonged stress reactions for the symptomatic woman and her parents. Facts of family history and relationships for three generations set the stage for stress reactions. Striking differences are evident in the physiology, family history, and contact with family of the nonsymptomatic woman. CONCLUSION(S) Differences warrant further study, a larger sample, and additional measures using hormone assay to establish connections between stress reactions in the family, endometriosis symptoms, and response to treatment. Further research will document changes in physiology and in symptoms that accompany interruption of stress reactions with self-regulation training and family systems psychotherapy.