Why does endometriosis cause such high rates of depression?

The relationship is likely bidirectional and complex. Chronic pain, hormonal fluctuations, disrupted sleep, fertility anxiety, and the often years-long diagnostic journey — average diagnosis takes 6-8 years in Australia — all contribute. Inflammation pathways in endometriosis may also have direct neurological effects. The research establishes a strong association and the clinical importance of assessing both physical and mental health.

Should I ask my GP to screen for depression if I have endometriosis?

The research findings suggest routine mental health screening as part of endometriosis care is clinically appropriate. If you have endometriosis and are experiencing low mood, anxiety, or persistent psychological distress, raising this with your GP or specialist is a reasonable step — they can use validated tools to assess and connect you with appropriate support.

New data: half of Australian women with endometriosis are living with depression

What just happened

A new nationally representative study of 9,000 Australian women has found that women living with endometriosis or PMOS (polyendocrine metabolic ovarian syndrome) are experiencing rates of depression and suicidal ideation far above the general population — and the mental health system is largely absent from their care pathway.

The Beyond the Surface 2026 report, produced by Women’s Mental Health Australia and described by The George Institute for Global Health, found that nearly 50% of women with endometriosis or PMOS are living with depression — rates up to 2.2 times higher than the general female population. More striking still: 13% of women with endometriosis and 10% with PMOS reported suicidal ideation or self-harm, compared to 4% across the full sample.

These are Australian women. This is Australian data. It puts numbers to what clinicians in this space have been observing for years — and makes the clinical case for a change in how care is structured.

Both-and

The double burden

Endometriosis affects approximately one in nine Australian women of reproductive age. The average diagnostic delay in Australia is six to eight years — years in which women typically experience chronic pelvic pain, painful periods, pain with intercourse, bowel or bladder symptoms, and for some, significant fertility implications. During those years, many are told the pain is exaggerated, psychosomatic, or within the normal range.

A 50% depression rate is not evidence that endometriosis is a psychiatric condition. It is evidence that living with a chronic pain condition — while fighting to be believed, while waiting years for diagnosis, while managing symptoms that intrude on every aspect of daily life — takes a measurable psychological toll. The biology reinforces this: chronic pain sensitisation, inflammatory mediators, hormonal fluctuation, disrupted sleep, and the psychosocial consequences of a condition that is often invisible to others all contribute to depression risk.

The data is not surprising. It is, however, now quantified at national scale.

The PMOS question

The second condition named in the report — PMOS, or polyendocrine metabolic ovarian syndrome — warrants honest acknowledgement. This is not a term in widespread current clinical use in Australia. It appears in the report and in the George Institute’s summary, but the public-facing research release does not fully define its diagnostic criteria or relationship to better-known entities like PCOS (polycystic ovary syndrome). Whether PMOS represents a distinct clinical entity, a refined version of PCOS, or an emerging research framework is not yet clear from publicly available materials.

This is worth noting not to dismiss the finding — the association with elevated depression and suicidal ideation rates is clinically important — but to be honest about what clinicians can take away today. If you are seeing a patient who carries a PCOS diagnosis and is experiencing significant psychological distress, the evidence base for that association is well established. The PMOS data reinforces the same directional finding. How the terminology develops in peer-reviewed literature is worth watching.

What the research recommends

Professor Bronwyn Graham, Director of the Centre for Sex and Gender Equity in Health and Medicine, frames the problem directly: women are being asked to manage “two separate journeys, one for their body and one for their mind, and to find their own way between them at the point they are least able to.”

The recommendation is pragmatic. Not a new system. Not a new funding stream. Embed routine mental health screening and established referral pathways into the government-funded Endometriosis and Pelvic Pain Clinics that already exist across Australia. A validated depression screen at the point of existing specialist contact, and a clear pathway to psychological care from there.

This is the policy ask that general practice can support without waiting for structural overhaul.

What it means for GPs

The practical implication for general practice is direct: mental health screening in endometriosis care now has Australian population-scale data behind it.

If a patient presents with endometriosis, with suspected endometriosis, or with a history of pelvic pain conditions including possible PCOS — and you haven’t assessed their mental health in recent consultations — the data suggests you should. A PHQ-9 takes three minutes. The 13% suicidal ideation rate across the endometriosis cohort means that asking directly about distress is not alarmist; it is appropriate clinical care.

The 1-in-8 figure also asks something of the consultation itself: not just the screening tool, but the question behind it. “How are you going emotionally with all of this?” belongs in the consultation. The data says it should be routine.

What the numbers don’t fully answer

The 13% suicidal ideation rate warrants careful reading. Suicidal ideation in this context likely covers a spectrum from passive thoughts to more active ideation, and the report as summarised does not distinguish between them. The clinical response differs substantially depending on where on that spectrum a patient sits. The number is significant; the clinical obligation it creates is to assess appropriately and act on what you find — not simply to refer to psychology and move on.

My two cents

For patients who have been managing endometriosis for years: the psychological weight is real, documented, and not something the health system has addressed well. That is not a failing on your part. It is a structural gap in how care has been designed — one that research like this is trying to move.

For clinicians: the argument for routine mental health screening in endometriosis care is now made with Australian population numbers. The clinic infrastructure to act on this exists. What’s needed is for the psychological journey and the physical one to stop being treated as two separate referral pathways that patients are expected to navigate on their own.

Verdict: yes — Australian population data now quantifies the mental health burden of endometriosis, and the clinical implication is routine screening, not reactive referral.

If you need support now: Lifeline 13 11 14 (24/7, call or text 0477 13 11 14) · Beyond Blue 1300 22 4636 · 13YARN (First Nations) 13 92 76 · In an emergency call 000.

Sources cited

New research reveals mental health toll of endometriosis and PMOS. The George Institute for Global Health, 18 August 2026. https://www.georgeinstitute.org/news-and-media/news/new-research-reveals-mental-health-toll-of-endometriosis-and-pmos