ABLE: Adapting to Better Life with Endometriosis

Background

Endometriosis is a chronic inflammatory condition affecting 10% of women aged 15-49 globally, or approximately 42 million in India alone, causing symptoms like chronic pelvic pain, dysmenorrhea, infertility, and reduced psychological well-being. Despite this burden, it remains neglected in Indian policy and research, with current medical/surgical treatments failing to improve quality of life, while psychological interventions show promise in high-income settings. High out-of-pocket costs and lack of economic burden data further highlight the urgent need for targeted research in diverse Indian contexts.

Aims

• Co-develop and test a psychological intervention to reduce depression and improve quality of life for women with endometriosis.

• Assess the economic burden of endometriosis, including out-of-pocket expenses and lost time for women and their families.

Research Methodology

An individual randomized controlled trial (RCT) with 480 women (18-49 years, PHQ-9 ≥5) at tertiary hospitals, randomized 1:1 to ABLE (Behavioral Activation Treatment for Depression-based: 8 group sessions every 3 weeks with education, therapy, mindfulness, homework) or usual care; outcomes via WHOQOL-BREF (primary) and PHQ-9 (secondary) at baseline, 6, and 12 months.

Cross-sectional economic analysis of direct/indirect costs; pilot testing, FGDs for feasibility; 3-year timeframe.

Sites: Guwahati Medical College and Hospital (Assam); Kasturba Medical College, Manipal (Karnataka).

Current Status

The ABLE study pilot will begin with screening and baseline assessments on March 2026, followed by BA group and individual sessions starting in April 2026. Screening and baseline for the main intervention are scheduled for May 2026. After the pilot, the intervention will be refined based on learnings, and the main study rollout is expected to begin in June 2026.

Read our stakeholder engagement report based on the consultation held on 6 February 2026, bringing together experts and a patient advocate to identify priority research areas and approaches to addressing endometriosis and gynaecological morbidity in India.