Almut Bauder, Harald Werneck
Background/Objectives: Endometriosis affects around 10% of women of reproductive age and is commonly associated with pelvic pain, fatigue and infertility. Beyond physical symptoms, the condition can substantially affect psychosocial well-being. However, self-esteem has typically been considered only indirectly in this context. This study examines how women with medically diagnosed endometriosis describe self-esteem in relation to the condition and the contexts in which it appears to be weakened or strengthened. Methods: Nine women with medically diagnosed endometriosis participated in semi-structured interviews (in person or online) between March and May 2025. Data were analyzed using Focused Interview Analysis with MAXQDA. Results: Self-esteem emerged as a recurring theme across everyday functioning, body-related experiences and, in some cases, fertility-related concerns. Self-esteem-related difficulties were described across different levels of symptom burden and were often discussed in relation to functional limitations, perceived reliability, loss of control, and high internal performance standards. Experiences of social and medical invalidation were frequently linked to self-doubt, withdrawal and self-invalidation. At the same time, participants described acceptance, self-compassion, boundary-setting, and the re-evaluation of femininity as experiences associated with a more stable sense of self-esteem. Conclusions: The findings suggest that self-esteem-related experiences were discussed in relation to functional limitations, experiences of being taken seriously, and available psychosocial resources. Self-esteem-related dynamics may represent a clinically relevant dimension to consider in psychosocial support for patients with endometriosis.