"It has been demonstrated that pelvic pain has significant negative effects on womens mental health and quality of life; in particular, women who suffer from pelvic pain report high levels of anxiety and depression, loss of working ability, limitations in social activities and a poor quality of life"

Risk factors
Genetics
Endometriosis is a heritable condition that is influenced by both genetic and environmental factors. Children or siblings of people with endometriosis are at higher risk of developing endometriosis themselves; low progesterone levels may be genetic, and may contribute to a hormone imbalance. There is an approximate six-fold increased incidence in individuals with an affected first-degree relative.It has been proposed that endometriosis results from a series of multiple hits within target genes, in a mechanism similar to the development of cancer. In this case, the initial mutation may be either somatic or heritable.Individual genomic changes (found by genotyping including genome-wide association studies) that have been associated with endometriosis include 9 locis robustly replicated in various MNAs reaching genome-wide significance :
There are many findings of altered gene expression and epigenetics, but both of these can also be a secondary result of, for example, environmental factors and altered metabolism. Examples of altered gene expression include that of miRNAs. Environmental toxins
Some factors associated with endometriosis include:

prolonged exposure to estrogen; for example, in late menopause or early menarche
obstruction of menstrual outflow; for example, in Müllerian anomaliesSeveral studies have investigated the potential link between exposure to dioxins and endometriosis, but the evidence is equivocal and potential mechanisms are poorly understood.
Complications
Physical Health
Complications of endometriosis include internal scarring, adhesions, pelvic cysts,  chocolate cysts of ovaries, ruptured cysts, and bowel and ureter obstruction resulting from pelvic adhesions. Endometriosis-associated infertility can be related to scar formation and anatomical distortions due to the endometriosis.Ovarian endometriosis may complicate pregnancy by decidualization, abscess and/or rupture.Thoracic endometriosis can be associated with recurrent thoracic endometriosis syndrome at times of a menstrual period that includes catamenial pneumothorax in 73% of women, catamenial hemothorax in 14%, catamenial hemoptysis in 7%, and pulmonary nodules in 6%.A 20-year study of 12,000 women with endometriosis found that individuals under 40 who are diagnosed with endometriosis are 3 times more likely to have heart problems than their healthy peers.Endometriosis may increase about 1% or less chance of getting ovarian, breast and thyroid cancers in women compared with those without.It results in few deaths with unadjusted and age-standardized death rates of 0.1 and 0.0 per 100,000.Sciatic endometriosis also called catamenial or cyclical sciatica is a sciatica whose cause is endometriosis and whose incidence is unknown. Diagnosis is usually made by an MRI or CT-myelography. Mental Health
"Endometriosis is associated with an elevated risk of developing depression and anxiety disorders". Studies suggest this is partially due to the pelvic pain experienced by endometriosis patients.