The psychosocial impact of endometriosis on South Indian women: a qualitative study

Abstract Background Endometriosis affects an estimated 10% of reproductive-aged women globally, yet remains underdiagnosed and poorly understood, particularly in low- and middle-income settings. In South India, sociocultural expectations surrounding menstruation, fertility, and gender roles may uniquely shape women’s experiences. This study explored the psychosocial impact of endometriosis on South Indian women and the cultural factors influencing their healthcare engagement. Methods We conducted semi-structured interviews with 13 women aged 31–48 years (mean = 37.2) with surgically or radiologically confirmed endometriosis, recruited from a specialist women’s hospital in Chennai. Interviews in English or Tamil were transcribed verbatim and analysed thematically using Braun and Clarke’s six-phase approach. Results Five themes were identified: (1) delayed recognition of symptoms due to pain normalisation and healthcare-seeking only after marriage; (2) fertility anxiety shaped by cultural pressure to conceive and fear of infertility; (3) navigating modern womanhood while balancing education, employment, and traditional expectations; (4) healthcare interactions, including trust in medical authority and use of complementary medicine; and (5) social dynamics characterised by stigma, secrecy, and variable partner and peer support. Conclusions Endometriosis imposes substantial psychological and social burdens on South Indian women. Culturally responsive care, public education, and supportive workplace and community strategies could improve early recognition, reduce stigma, and enhance quality of life.