Association between clinically suspected endometriosis lacking histologic evidence and anxiety, depression and cannabidiol-containing products.
7 affiliations
- 1Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
- 2Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
- 3Cancer Prevention and Control Program, Samuel Oschin Comprehensive Cancer Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
- 4Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
- 5Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
- 6Department of Obstetrics and Gynecology, UT Health San Antonio, San Antonio, TX, USA.
- 7Center for Inherited Oncogenesis, UT San Antonio, San Antonio, TX, USA.
Abstract
Endometriosis is a common gynecologic condition, characterized by the growth of endometrial-like epithelial and stromal cells at ectopic sites, most commonly within the peritoneal cavity. Disease symptoms associate poorly with lesion burden, and severe symptoms of endometriosis can occur in patients in whom lesions cannot be detected by surgical inspection or pathologic examination of excised biopsies. Anxiety and depression are prevalent in patients with confirmed endometriosis. Additionally, recent evidence highlights an increasing prevalence of cannabinoid-containing products for management of pelvic pain. This study aimed to examine these comorbid traits and cannabinoid-containing products use in patients with "clinically suspected endometriosis with negative pathology" (CSENP). This study used data collected through The Biologic and Epidemiologic Markers of Endometriosis (BEME) clinic-based study at a quaternary hospital in Los Angeles, California. 454 patients were included. After multivariable regression analysis, CSENP patients were at higher risk of depression compared to confirmed cases [adjusted odds ratio (aOR) 2.27; 95% confidence interval (CI) 1.03-5.03, p = .043]. Compared with women with endometriosis, controls were less likely to use cannabis for pain (aOR 0.32, 95% CI 0.16-0.64). Compared with patients with endometriosis, CSENP patients were also more likely to use cannabis for depression (aOR 1.92, 95% CI 1.01-3.65). Even in the absence of histopathologic confirmation of lesions, patients with pain symptoms similar to those found in endometriosis have similar patterns of anxiety and depression which may require long-term management. Long-term follow-up of CSENP patients will be valuable to optimize the best strategies for clinical care. Data presented for cannabis use should be interpreted with caution due to the observational nature of the data, lack of information on dosage, and concerns about known side-effects of long-term use.
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BibTeX
@article{meyer2026association,
title = {{Association between clinically suspected endometriosis lacking histologic evidence and anxiety, depression and cannabidiol-containing products.}},
author = {Raanan Meyer and Jennifer Sun and Christina Lombardi and Maya Shats and Pak Hin Yu and Forough Abbasi and Ashley Berberian and Anthony Manlinguez and Shruti Kulkarni and Margareta Pisarska and Fabiola Medeiros and Marc T Goodman and Kate Lawrenson and Matthew Siedhoff and Kelly N Wright},
journal = {European journal of obstetrics \& gynecology and reproductive biology: X},
year = {2026},
month = oct,
doi = {10.1016/j.eurox.2026.100500},
url = {https://europepmc.org/article/MED/42926793},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Association between clinically suspected endometriosis lacking histologic evidence and anxiety, depression and cannabidiol-containing products.
AU - Raanan Meyer
AU - Jennifer Sun
AU - Christina Lombardi
AU - Maya Shats
AU - Pak Hin Yu
AU - Forough Abbasi
AU - Ashley Berberian
AU - Anthony Manlinguez
AU - Shruti Kulkarni
AU - Margareta Pisarska
AU - Fabiola Medeiros
AU - Marc T Goodman
AU - Kate Lawrenson
AU - Matthew Siedhoff
AU - Kelly N Wright
PY - 2026
DA - 2026/10/12
JO - European journal of obstetrics & gynecology and reproductive biology: X
DO - 10.1016/j.eurox.2026.100500
UR - https://europepmc.org/article/MED/42926793
AB - Endometriosis is a common gynecologic condition, characterized by the growth of endometrial-like epithelial and stromal cells at ectopic sites, most commonly within the peritoneal cavity. Disease symptoms associate poorly with lesion burden, and severe symptoms of endometriosis can occur in patients in whom lesions cannot be detected by surgical inspection or pathologic examination of excised biopsies. Anxiety and depression are prevalent in patients with confirmed endometriosis. Additionally, recent evidence highlights an increasing prevalence of cannabinoid-containing products for management of pelvic pain. This study aimed to examine these comorbid traits and cannabinoid-containing products use in patients with "clinically suspected endometriosis with negative pathology" (CSENP). This study used data collected through The Biologic and Epidemiologic Markers of Endometriosis (BEME) clinic-based study at a quaternary hospital in Los Angeles, California. 454 patients were included. After multivariable regression analysis, CSENP patients were at higher risk of depression compared to confirmed cases [adjusted odds ratio (aOR) 2.27; 95% confidence interval (CI) 1.03-5.03, p = .043]. Compared with women with endometriosis, controls were less likely to use cannabis for pain (aOR 0.32, 95% CI 0.16-0.64). Compared with patients with endometriosis, CSENP patients were also more likely to use cannabis for depression (aOR 1.92, 95% CI 1.01-3.65). Even in the absence of histopathologic confirmation of lesions, patients with pain symptoms similar to those found in endometriosis have similar patterns of anxiety and depression which may require long-term management. Long-term follow-up of CSENP patients will be valuable to optimize the best strategies for clinical care. Data presented for cannabis use should be interpreted with caution due to the observational nature of the data, lack of information on dosage, and concerns about known side-effects of long-term use.
SN - 2590-1613
ER -