Investigate how women with self-reported endometriosis, polycystic ovary syndrome (PCOS), or no known reproductive disease perform on the Reading the Mind in the Eyes task, a metric of social cognitive empathic abilities, and how these scores are mediated by self-reported pelvic pain, depression levels, and medication use.
Design:
Cross-sectional.
Setting:
Online survey.
Population:
Saskatchewan; mixed ethnicities.
Methods:
Participants (n = 342) completed surveys on diagnoses of endometriosis and PCOS, levels of pelvic pain, medications, depression, and cognitive empathy (the Reading the Mind in the Eyes task, RMET).
Results:
Women with endometriosis showed lower scores on the RMET, compared to unaffected women and women with PCOS. However, among women with endometriosis, higher levels of pelvic pain and higher scores on an index of depression were associated with enhanced RMET performance. Among women with PCOS, medication with spironolactone, an androgen receptor antagonist, was associated with higher RMET scores, compared to women with PCOS who were not medicated or who were taking different medications.
Conclusions:
Symptoms (including pelvic pain), hormonal correlates, and some treatments of PCOS and endometriosis mediated variation in cognitive empathy.
BulunSEYilmazBDSisonC, et al. Endometriosis. Endocr Rev2019; 40(4): 1048–1079.
2.
OnoYJTanabeANakamuraY, et al. A low-testosterone state associated with endometrioma leads to the apoptosis of granulosa cells. PLoS One2014; 9(12): e115618.
3.
DinsdaleNLCrespiBJ.Revisiting the wandering womb: oxytocin in endometriosis and bipolar disorder. Horm Behav2017; 96: 69–83.
4.
HuangMLiXGuoP, et al. The abnormal expression of oxytocin receptors in the uterine junctional zone in women with endometriosis. Reprod Biol Endocrinol2017; 15(1): 1–10.
5.
YarmolinskayaMKhobetsVTralT, et al. The potentialities of oxytocin receptor inhibitors for endometriosis therapy. Gynecol Endocrinol2020; 36: 16–19.
6.
DinsdaleNNepomnaschyPCrespiB.The evolutionary biology of endometriosis. Evol Med Public Health2021; 9(1): 174–191.
7.
FauserBCJMTarlatzisBCRebarRW, et al. Consensus on women’s health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril2012; 97(1): 28–38.e25.
8.
RosenfieldRLEhrmannDA.The pathogenesis of polycystic ovary syndrome (PCOS): the hypothesis of PCOS as functional ovarian hyperandrogenism revisited. Endocr Rev2016; 37(5): 467–520.
9.
GoodmanNFCobinRHFutterweitW, et al. American Association of Clinical Endocrinologists, American College of Endocrinology, and androgen excess and PCOS society disease state clinical review: guide to the best practices in the evaluation and treatment of polycystic ovary syndrome - part 1. Endocr Pract2015; 21(11): 1291–1300.
10.
JahromiBNDabbaghmaneshMHBakhshaieP, et al. Assessment of oxytocin level, glucose metabolism components and cutoff values for oxytocin and anti-mullerian hormone in infertile PCOS women. Taiwan J Obstet Gynecol2018; 57(4): 555–559.
11.
ReiCWilliamsTFeloneyM.Endometriosis in a man as a rare source of abdominal pain: a case report and review of the literature. Case Rep Obstet Gynecol2018; 2018: 2083121.
12.
WalfAAFryeCA.A review and update of mechanisms of estrogen in the hippocampus and amygdala for anxiety and depression behavior. Neuropsychopharmacology2006; 31(6): 1097–1111.
13.
GiltayEJEnterDZitmanFG, et al. Salivary testosterone: associations with depression, anxiety disorders, and antidepressant use in a large cohort study. J Psychosom Res2012; 72(3): 205–213.
14.
FacchinFBarbaraGSaitaE, et al. Impact of endometriosis on quality of life and mental health: pelvic pain makes the difference. J Psychosom Obstet Gynaecol2015; 36(4): 135–141.
15.
DeeksAAGibson-HelmMETeedeHJ.Anxiety and depression in polycystic ovary syndrome: a comprehensive investigation. Fertil Steril2010; 93(7): 2421–2423.
16.
CrespiBJ.Oxytocin, testosterone, and human social cognition. Biol Rev2016; 91(2): 390–408.
17.
de WaalFBMPrestonSD. Mammalian empathy: behavioural manifestations and neural basis. Nat Rev Neurosci2017; 18(8): 498–509.
18.
DomesGHeinrichsMMichelA, et al. Oxytocin improves “mind-reading” in humans. Biol Psychiatry2007; 61(6): 731–733.
19.
KhorashadBSKhazaiBRoshanGM, et al. Prenatal testosterone and theory of mind development: findings from disorders of sex development. Psychoneuroendocrinology2018; 89: 250–255.
20.
RiemMMEBakermans-KranenburgMJVoorthuisA, et al. Oxytocin effects on mind-reading are moderated by experiences of maternal love withdrawal: an fMRI study. Prog Neuropsychopharmacol Biol Psychiatry2014; 51: 105–112.
21.
SchwaigerMHeinrichsMKumstaR.Oxytocin administration and emotion recognition abilities in adults with a history of childhood adversity. Psychoneuroendocrinology2019; 99: 66–71.
22.
MischkowskiDCrockerJWayBM.From painkiller to empathy killer: acetaminophen (paracetamol) reduces empathy for pain. Soc Cogn Affect Neurosci2016; 11(9): 1345–1353.
23.
HarknessKSabbaghMJacobsonJ, et al. Enhanced accuracy of mental state decoding in dysphoric college students. Cogn Emot2005; 19(7): 999–1025.
24.
RichmanMJUnokaZ.Mental state decoding impairment in major depression and borderline personality disorder: meta-analysis. Br J Psychiatry2015; 207(6): 483–489.
25.
SirmansSMPateKA.Epidemiology, diagnosis, and management of polycystic ovary syndrome. Clin Epidemiol2013; 6: 1–13.
26.
SelakVFarquharCPrenticeA, et al. Danazol for pelvic pain associated with endometriosis. Cochrane Database Syst Rev2001; 4: CD000068.
27.
Baron-CohenSWheelwrightSHillJ, et al. The “Reading the Mind in the Eyes” Test revised version: a study with normal adults, and adults with Asperger syndrome or high-functioning autism. J Child Psychol Psychiatry2001; 42(2): 241–251.
International Pelvic Pain Society. Pelvic pain assessment form, https://www.pelvicpain.org/ (2008, accessed 9 July 2021).
30.
RenQLuXZhaoQ, et al. Can self-pain sensitivity quantify empathy for others’ pain?Psychophysiology2020; 57(10): e13637.
31.
MischkowskiDCrockerJWayBM.A social analgesic? A cetaminophen (paracetamol) reduces positive empathy. Front Psychol2019; 10: 538.
32.
van HonkJSchutterDJBosPA, et al. Testosterone administration impairs cognitive empathy in women depending on second-to-fourth digit ratio. Proc Natl Acad Sci USA2011; 108(8): 3448–3452.
33.
DinsdaleNLCrespiBJ.Endometriosis and polycystic ovary syndrome are diametric disorders. Evol Appl2021; 14: 1693–1715.
34.
AgostiniAScaioliEBelluzziA, et al. Attachment and mentalizing abilities in patients with inflammatory bowel disease. Gastroenterol Res Pract2019; 2019: 7847123.
35.
InancLBodurNEParlakSÇ, et al. Relationship between mentalizing abilities, attachment styles, anxiety and depressive symptom levels in fibromyalgia patients. Dusunen Adam J Psychiatry Neurol Sci2019; 32: 113.
36.
Di TellaMCastelliLColonnaF, et al. Theory of mind and emotional functioning in fibromyalgia syndrome: an investigation of the relationship between social cognition and executive function. PLoS One2015; 10(1): e0116542.
37.
ShinNYKangDHJangJH, et al. Impaired recognition of social emotion in patients with complex regional pain syndrome. J Pain2013; 14(11): 1304–1309.
38.
GuoSWMaoXMaQ, et al. Dysmenorrhea and its severity are associated with increased uterine contractility and overexpression of oxytocin receptor (OTR) in women with symptomatic adenomyosis. Fertil Steril2013; 99(1): 231–240.
39.
PevelerREdwardsJDaddowJ, et al. Psychosocial factors and chronic pelvic pain: a comparison of women with endometriosis and with unexplained pain. J Psychosom Res1996; 40(3): 305–315.
40.
LorençattoCAlberto PettaCJosé NavarroM, et al. Depression in women with endometriosis with and without chronic pelvic pain. Acta Obstet Gynecol Scand2006; 85(1): 88–92.
41.
BrooksTSharpREvansS, et al. Predictors of depression, anxiety and stress indicators in a cohort of women with chronic pelvic pain. J Pain Res2020; 13: 527–536.
42.
WarzechaDSzymusikIWielgosM, et al. The impact of endometriosis on the quality of life and the incidence of depression—a cohort study. Int J Env Res Public Health2020; 17(10): 3641.
43.
HarknessKLJacobsonJADuongD, et al. Mental state decoding in past major depression: effect of sad versus happy mood induction. Cogn Emot2010; 24(3): 497–513.
44.
TuckerDMLuuPDerryberryD.Love hurts: the evolution of empathic concern through the encephalization of nociceptive capacity. Dev Psychopathol2005; 17(3): 699–713.
45.
ZhengPZhangWLengJ, et al. Research on central sensitization of endometriosis-associated pain: a systematic review of the literature. J Pain Res2019; 12: 1447–1456.
46.
CaroneLOxberrySGTwycrossR, et al. Spironolactone. J Pain Symptom Manag2017; 53(2): 288–292.
47.
LoboRAShoupeDSerafiniP, et al. The effects of two doses of spironolactone on serum androgens and anagen hair in hirsute women. Fertil Steril1985; 43(2): 200–205.
