Perceived cognitive functioning difficulties in individuals living with endometriosis

J Health Psychol. 2025 Dec;30(14):4314-4332. doi: 10.1177/13591053251331826. Epub 2025 Apr 24.

Abstract

Difficulties in cognitive functioning (e.g., memory, attention) are common in chronic conditions characterized by physical pain, fatigue and depression. Yet investigations in endometriosis are lacking. We aimed to assess: (1) perceived cognitive functioning, (2) the association of cognitive functioning with fatigue, pain and depressive symptoms, and (3) whether endometriosis treatments moderated these relationships. Participants (n = 1239) with diagnosed endometriosis completed an online survey assessing perceived cognitive functioning [Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog)], pain, fatigue and depression. FACT-Cog scores indicated cognitive impairments in 80% of participants. Hierarchical regression analyses demonstrated that greater pain, fatigue, and depressive symptoms were associated with poorer perceived cognitive functioning. Moderation analyses indicated that taking hormonal treatments or pain medications diminished the adverse effects of depression, but exacerbated the adverse effects of pain, on cognitive functioning. The extensive perceived cognitive difficulties evident in this sample suggests that supportive interventions to enhance cognitive functioning may be warranted.

Keywords: cognitive functioning; cognitive impairment; depression; endometriosis; fatigue; pain.

MeSH terms

  • Adult
  • Cognition*
  • Cognitive Dysfunction* / psychology
  • Depression / psychology
  • Endometriosis* / complications
  • Endometriosis* / psychology
  • Fatigue / psychology
  • Female
  • Humans
  • Middle Aged
  • Pain / psychology
  • Surveys and Questionnaires
  • Young Adult