[Acute psychological stress and endometriosis-related pain]

Endometriosis is a common chronic gynecological disease in which pain represents one of the most prominent symptoms. Although research has traditionally focused on inflammatory, hormonal and neurobiological mechanisms, increasing evidence suggests that psychological factors and stress-related processes also contribute to symptom development and persistence. This narrative review summarizes current evidence on the relationship between acute psychological stress and endometriosis-related pain within a biopsychosocial framework, with particular emphasis on potential psychological mediating mechanisms and future research directions. Available evidence indicates that the relationship between stress and pain is complex and bidirectional, with cognitive appraisal, coping strategies and, in particular, pain catastrophising playing important roles. Current findings suggest that acute psychological stress is likely to influence short-term fluctuations in pain primarily through these psychological mechanisms rather than through a direct effect; however, empirical evidence on the temporal dynamics between stress and pain remains limited. Ecological Momentary Assessment and other longitudinal approaches provide promising opportunities to investigate these dynamic interactions in everyday life. A better understanding of the role of acute psychological stress may contribute to a more comprehensive interpretation of endometriosis-related pain and support the development of personalised, interdisciplinary patient care. Orv Hetil. 2026; 167(42): 1693-1701.