Psychological Wellbeing Among South African Women with Endometriosis: A Quantitative Study

Researcher: Raeesah Ismail from the Department of Psychology (University of the

Witwatersrand) under the supervision of Dr S Rogers, research conducted in 2025.

Citation: Ismail, Raeesah. (2025). Psychological Wellbeing Among South African Women

with Endometriosis: A Quantitative Study. [Master's dissertation, University of the

Witwatersrand, Johannesburg]. WIReDSpace. https://hdl.handle.net/10539/47828

What Is The Study About?

This study explored the experiences and psychological wellbeing of South African women

living with endometriosis (endo). It looked at how factors like delayed diagnosis, healthcare

experiences, social support, and financial strain can affect every day wellbeing and quality of

life. The research included 248 South African women diagnosed with endo from different

backgrounds and provinces across the country. It aimed to better understand the emotional

and psychological impact that often goes unseen and more often, dismissed or invalidated.

Why Is This Important?

Endometriosis affects far more than just physical health. Many women live with chronic pain,

emotional distress, loneliness, financial pressure, and years of feeling dismissed or

misunderstood before receiving answers. These experiences can affect relationships, work,

education, confidence, and overall mental wellbeing. In South Africa, research on

endometriosis is still extremely limited, but more local and international studies are

beginning to discover and unpack the real impact this condition has on women’s lives and the

urgent need for better awareness, earlier diagnosis, accessibility to care, and more

compassionate healthcare support.

What We Know...

Research already shows that many women with endo struggle with pain, fatigue, anxiety,

isolation, and difficulties at work, school, and in relationships. Many also experience long

delays before being diagnosed and often feel unsupported within healthcare settings.

International research has increasingly recognised that endometriosis affects mental and

emotional wellbeing just as much as physical health. However, there is still very little

research focused specifically on the psychological wellbeing and lived experiences of South

African women with endometriosis, making local research in this area especially important.

What Was Discovered...

The study found that financial strain, difficulties accessing healthcare, coupled with the

emotional impact of endo had the biggest effect on psychological wellbeing. Women facing

greater socioeconomic challenges often reported poorer psychological wellbeing overall,

particularly when they struggled to access consistent medical care and support. The cost of

consultations, surgery, medication, transport, and ongoing treatment can place immense

financial strain on individuals and families, especially in a healthcare system where access to

specialised care is uneven. Many women also experience disruptions to work, education, and

daily functioning because of chronic pain and fatigue, further affecting emotional wellbeing

and quality of life.

In this study, socioeconomic strain unsurprisingly emerged as one of the strongest factors

linked to poorer psychological wellbeing. The findings also highlighted the importance of

improving awareness, validating women’s experiences, and including mental health support

as part of endometriosis care in South Africa. Overall, the research reinforces the need to

view endometriosis as a whole-body and whole-person condition, not just a reproductive or

menstrual issue.

Awareness Is The First Step

One of the clearest messages from this research is that awareness matters - not only public

awareness, but also medical awareness. Many women with endometriosis spend years feeling

unheard, dismissed, or told that their pain is “normal,” which can delay diagnosis and

negatively affect psychological wellbeing. The study found that experiences of medical

support were closely linked to psychological wellbeing, highlighting how important it is for

healthcare professionals to recognise, validate, and respond appropriately to women’s

symptoms. Awareness of the multidimensional levels is the first step to solve anything.

Increasing education around menstrual health and endometriosis can help women seek

support earlier and feel more empowered in their healthcare journeys. At the same time,

improving awareness and training within healthcare systems may help reduce stigma,

improve patient experiences, and encourage earlier diagnosis and intervention. More local

and international research is also beginning to give visibility to the lived experiences of

women with endometriosis, helping to challenge misconceptions and advocate for more

compassionate, holistic care.

When women’s pain is recognised earlier, believed sooner, and supported properly, it doesn’t

only change health outcomes, it also changes her quality of life. Endometriosis is not ‘just

bad periods’ it is a serious chronic illness that deserves awareness, research, and

compassionate care.