Relationships and Intimacy across the lifespan

Question 1

adolescent friendships

Answer 1

• At this point in development children are transitioning from children to adults.
• They start shifting social time from family to friends more and develop romantic relationships.
• In WEIRD societies, at this point children start to experience conflict with their parents usually because of disagreeing the pace at which the child becomes autonomous.
• In non-WEIRD cultures however, parents hold more authority and as such children are less likely to rebut their parents which limits conflict (Phinney at al., 2005).
• The typical adolescent has four to six close friends (French & Cheung, 2018).
• Adolescent friendships are characterised by intimacy, self-disclosure, trust, and loyalty (Bowker & Ramsay, 2016).
• We have expectations that friends should:
  
  • offer support
  • stand up for them
  • keep their secrets
• Cooperation, sharing, intimacy, and affirmation in these friendships reflect development in perspective-taking, social sensitivity, empathy, and general social skills (Poulin & Chan, 2010).
• Friends tend to have similar demographics, such as age, ethnicity, and socioeconomic status (Bowker & Ramsay, 2016).
• Close and best friends share a similar orientation toward risky behaviours, such as:
  
  • Willingness to try drugs and engage in criminal behaviour
  • Participation in dangerous behaviours, including unprotected sex
• Friends share common interests in areas such as:
  
  • Music tastes
  • Academic achievement and educational aspirations
  • Political beliefs
  • Psychosocial development, including identity status (Markiewicz & Doyle, 2016)
• Over time, friends tend to become even more similar (Scalco et al., 2015).
• Some adolescents choose friends who are different from them, which helps them consider new perspectives.
• For example, cross-ethnic friendships are less common but have unique benefits
  
  • Decreases in prejudices over time (Titzmann et al., 2015)
  • Global majority individuals experience: Less discrimination, vulnerability, and relational victimisation
    Higher self-esteem and overall well-being
• Friendship stability:
• High-quality friendships are characterised by (Hiatt et al., 2015):
  
  • Sharing
  • intimacy
  • open communication
  • Longevity
• However, among early adolescents, 33% to 50% of friendships are unstable, with frequent changes in friendships (Poulin & Chan, 2010).
  After early adolescence, friendships become more stable, with young people retaining most friendships throughout a school year.

Question 2

adolescent romantic relationships

Answer 2

• Dating is a key part of the adolescent experience.
• By middle adolescence, many young people have been involved in at least one romantic relationship.
• By age 18, most adolescents have some dating experience.
• By late adolescence, the majority have been in an ongoing romantic relationship with one person (O’Sullivan et al., 2007).
• Dating progression (Connolly et al., 2013):
• Adolescents with larger social networks and more opposite-sex peers tend to date more.
• Some research suggests:
  
  • Adolescents may date outside their friendship networks
  • Pre-existing friendships are unlikely to turn into romantic relationships (Kreager et al., 2016)
• Like friendships, romantic partners often share similar traits, such as academic achievement (Giordano et al., 2008).
• Romantic relationships help adolescents learn to share, be sensitive to others’ needs, and develop intimacy.
• They provide opportunities to practice identity development and social support.
• In middle to late adolescence, romantic relationships are associated with:
  
  • Positive self-concept
  • Higher expectations for relationship success
  • Fewer feelings of alienation
  • Better physical and mental health (Connolly & McIsaac, 2011).

Question 3

sexual development in adolescents

Answer 3

• Sexual development can become a major source of conflict for the parent-child relationship.
• Issues surrounding sexual health and pregnancy depend on open communication and level of autonomy.
• There are cultural variations in the view of contraceptive use and age of sexual behaviour, however, a consistent finding is that premarital adolescent pregnancy is undesirable.
• Countries with the lowest rates of adolescent pregnancy are those which are either: accepting of sexual behaviour and promote contraceptive use or those which are very restrictive of sexual behaviour (Davis & Davis, 2012).
  By adolescence most are fully aware of their sexual orientation which, depending on the culture an individual is in, can lead to inner conflict. Sexual orientation can also be a cause of contention.

Question 4

early adult friendships

Answer 4

• Stage six of Erikson’s theory: Intimacy vs. Isolation
  
  • Focuses on developing intimate relationships while maintaining independence
• Key aspects of this stage:
  
  • Learning to share personal details and listen to others
  • Failure to achieve intimacy may lead to isolation or a lack of close relationships
• Intimacy in early adult friendships involves:
  
  • Openly sharing yourself with others
  • Reciprocating when others share
  • Experiencing a deepened connection and its benefits
  • Successfully balancing close relationships with autonomy
• Intimacy has very real benefits for mental and physical well-being.
• Humans are social creatures, so having a social network of people to lean on for support, guidance, and validation is crucial.
• Potential challenges in this stage:
  
  • Rejection when trying to deepen relationships
  • This may lead to withdrawal, low self-esteem, and confidence issues
  • This can ultimately result in isolation
• Friendship quality (rather than quantity) influences well-being (Demir, 2010).
• Three key features of friendship quality:
• These features change over time in early adulthood (Langheit & Poulin, 2022).
• Best friendships stand out in all quality features and satisfy social needs better than other friendships (Demir et al., 2007).
• The impact on wellbeing:
  
  • Self-esteem is positively associated with positive friendship quality (Pittman & Richmond, 2008).
  • Negative friendship quality can have a negative association with self-esteem (Sherman et al., 2006).
  • HOWEVER others found no association (Bagwell et al., 2005).
• Specific friendship features:
  
  • Intimacy (self-disclosure) is linked to lower loneliness (Rook, 1987)
  • Conflict with a friend is linked to higher loneliness (Heinrich & Gullone, 2006)
    Most studies have examined these associations cross-sectionally.

Question 5

early adult romantic relationships

Answer 5

• Once individuals reach adulthood, they are likely to leave the ‘family home’ which affects their fundamental social world.
• Leaving the daily support from parents and siblings places more emphasis on friendships and relationships, usually cohabiting with a romantic partner.
• When choosing a partner for marriage, the traits individuals prefer tend to be found universally (Buss, 2003).
• Buss (1989) collected data from 37 countries and listed the importance of mate traits for both females and males. The findings showed:
• Arranged marriages are marriages marriage where a person’s partner is purposefully selected by a third-party (usually parents or grandparents). They can be a way for families to maintain or elevate social class and maintain reputations within their community.
• In 2017, 55% of marriages worldwide were arranged marriages. However, how does an arranged marriage affect the relationship?
• Olcay Imamoğlu et al. (2018) examined the difference between arranged and self-selected marriages in a Turkish sample. They found:
  
  • spouses in self-selected marriages reported more love
  • wives in arranged marriages reported significantly less partnership than both the husbands and the wives in self-selected marriages
• Romantic relationships positively impact well-being (Baumeister & Leary, 1995).
• Romantic partners primarily fulfil intimacy needs, but friends also contribute.
• Dyadic Withdrawal Hypothesis:
  
  • Individuals tend to withdraw from friendships as they focus more on romantic relationships (Kalmijn, 2003; Milardo et al., 1983)
• Mixed Research Findings on Friendship vs. Romantic Relationships & Well-Being:
  
  • Some studies show friendship is the stronger predictor of well-being (Camirand & Poulin, 2022
  • In some cases, friendship’s impact on well-being remains or disappears when romantic relationships are considered (Walen & Lachman, 2000)
    Further studies are needed to clarify these associations.

Question 6

early adult parenthood

Answer 6

• Approximately 90% of young adults have children globally (United Nations, 2003).
• However, there are differences in opinions about parenthood cross-culturally:
  
  • In WEIRD countries:
  • Becoming a parent is largely a choice (those who do not want children have access to contraception)
  • Children can cost a substantial economic amount
  • Parents do most of the childcare
  • In non-WEIRD countries:
  • Becoming a parent is highly important
  • Infertility can lead to ostracism
  • There is a community responsibility for rearing children
• Nomaguchi and Milkie (2004) investigated the benefits and costs of becoming a parent. They compared males and females, as well as married versus unmarried (single). Across different aspects, the authors reported:

Question 7

mid adult friendships

Answer 7

• Friendships continue to have positive impacts on wellbeing through middle adulthood.
• Having a confidant significantly reduces the risk of psychiatric disorders like depression and anxiety (Newton et al., 2008).
• Friendship buffers against stress-related health issues (Hawkley et al., 2008).
• Poor social connectedness is a greater mortality risk than smoking, obesity, or excessive alcohol use (Holt-Lunstad et al., 2010).
• Gender differences in friendship and social support
• A study on social interactions and midlife well-being showed (Carmichael et al., 2015):
  
  • At age 20: High quantity of social interactions is beneficial
  • At age 30: The quality of friendships matters more than quantity
  • At age 50: Those who shifted from quantity to quality friendships had better psychological well-being
  • AND Those who continued wide socialising in their 30s had poorer intimacy and worse psychological outcomes

Question 8

mid adult friendships (the internet)

Answer 8

• Many people use the internet to meet and make new friends yes, some researchers question whether online friendships lack authenticity.
• Research suggests online relationships can be just as intimate and sometimes even more so (Bargh et al., 2002).
• Socially anxious or lonely individuals are more likely to form meaningful friendships online (McKenna, Green, & Gleason, 2002).
  For high-functioning autistic individuals, online communication facilitates relationship development in ways that face-to-face interaction may not (Benford, 2008).

Question 9

mid adult friendships (the workplace)

Answer 9

• Since people spend as much or more time at work than with family and friends and friendships often develop in the workplace.
• Work friendships provide mentoring, social support, and resources, but they can also lead to conflicts.
• Collaborative work projects often serve as a foundation for friendships, making work more enjoyable (Elsesser & Peplau, 2006).
• Employees in workplaces that encourage friendships report greater job satisfaction, involvement, and commitment and are less likely to leave (Riordan & Griffeth, 1995).

Question 10

mid adulthood family

Answer 10

• The sandwich generation = middle-aged adults who are simultaneously supporting their aging parents and their own children.
• Key Statistics (Parker & Patten, 2013)
  
  • 47% of middle-aged adults fall into this category
  • 15% provide financial support to both an older parent and their children
  • 48% have supported their adult children in the past year
  • 27% are the primary source of financial support for their grown children
• Challenges Faced by the Sandwich Generation:
  
  • Emotional and financial Strain: Balancing caregiving for elderly parents while raising/supporting children can cause stress and financial difficulties
  • Time constraints: Managing multiple caregiving responsibilities can lead to burnout
  • Impact on work & personal life: Many struggle with career responsibilities while fulfilling family obligations
• Kinkeeping = the role of maintaining family connections, promoting solidarity, and preserving family history (Brown & DeRycke, 2010).
  
  • These individuals organise gatherings, provide advice, and strengthen familial bonds.
• Who Are the Kinkeepers?
  
  • Studies show that 86% of kinkeepers are women (Leach & Braithwaite, 1996).
  • Common Kinkeepers are mothers, grandmothers and older female relatives.
• The Burden of Kinkeeping
  
  • Time Commitment: Kinkeepers spend nearly 34 hours per month maintaining family ties (Gerstel & Gallagher, 1993)
  • Emotional Strain: The more kin they support, the higher their stress and depression levels
    Caregiving Overlap: Some kinkeeping tasks include transportation, meal preparation, and household repairs, adding to their workload

Question 11

mid adult romantic relationships

Answer 11

• Literature on romantic relationships in middle adulthood is scarce.
• A study by Brown et al. (2021) compared the relationship quality of U.S. midlife adults in those: dating, living apart together (LAT) relationships, cohabitation, and marriage.
• Data were drawn from the 2013 Families and Relationships Survey, a nationally representative survey of U.S. adults.
• The analytic sample was composed of adults aged 50–65 in a partnership (N=2,166).
• Of the sample:
  
  • 82.9% were married
  • 5.4% of partnered midlife adults were in a LAT relationship
  • 8.2% of partnered midlife adults were cohabiting
  • 31% of unmarried partnerships in midlife were LAT relationships
  • Relationship quality of midlife cohabiting and married individuals was largely indistinguishable in terms of support, disagreement, and instability.
• Midlife cohabitors were less happy in their relationships, on average, than are married individuals.

Question 12

older adult friendships

Answer 12

• Friendships in later life are typically not formed for status or career enhancement but based on connection and mutual enjoyment.
• Most elderly individuals have at least one close friend, and these friendships often provide both emotional and physical support.
• Having someone to talk to and rely on is crucial during this life stage.
• Research by Bookwala et al. (2014) found that the presence of a close friend can significantly protect health after the loss of a spouse (widowhood).
• Those who were widowed and had a friend as a confidante reported:
  
  • Lower somatic depressive symptoms
  • Better self-rated health
  • Fewer sick days
    In contrast, having a family member as a confidante did not provide the same level of health protection for widowed individuals.

Question 13

older adulthood family

Answer 13

• Older adults often provide financial and housing support to their adult children, with more support flowing from parent to child than the other way around (Fingerman & Birditt, 2011).
• Many older adults also take on the role of raising their grandchildren in addition to supporting their own children.
• The Berlin Aging Study (BASE) found that older adults who received emotional support (e.g., affection, encouragement) from their children reported greater life satisfaction (Lang & Schütze, 2002).
• In contrast, those who received informational support (e.g., advice) from their children reported lower life satisfaction.
• Daughters and younger adult children were more likely to provide emotional support than sons or older adult children.
  Autonomous adult children—those who were independent rather than emotionally dependent—had more meaningful relationships with their aging parents from both perspectives.

Question 14

older adulthood romantic relationships

Answer 14

• Older marriages show more positive and fewer negative interactions than middle-aged marriages (Carstensen et al., 1995).
• Older partners display more affection during conflicts, suggesting a shift toward emotional regulation and harmony.
• Challenges faced by older LGBT+ adults:
• Health Disparities:
  
  • Higher rates of smoking and binge drinking compared to heterosexuals
  • Increased risk of prostate cancer, HIV, and STIs (CDC, 2008)
• Limited Social Support:
  
  • More likely to live alone (twice as likely as heterosexuals)
  • Four times less likely to have adult children who can provide care (Hillman & Hinrichsen, 2014)
• Discrimination and Intersectionality:
  
  • Ageism, heterocentrism, sexism, and racism can compound stressors
  • Older gay Black men report higher levels of racism than younger gay Black men and more ageism than older gay white men (David & Knight, 2008)
• Older LGBT+ adults:
• Resilience and Social Networks
  
  • Chosen Families: Many rely on friends and “family by choice” rather than biological relatives for support (Hillman & Hinrichsen, 2014)
  • Spiritual and Wellness Activities: Over 80% engage in some form of wellness or spiritual activity (Fredrickson-Goldsen et al., 2011)
• The Role of Cohort Differences
  
  • Older generations (1950s) lacked legal protections and faced criminalisation of their identities
  • Baby boomers (1960s–70s) saw progress, including repeals of discriminatory laws
  • Future generations will benefit from same-sex marriage rights and increasing societal acceptance

Question 15

older adult loneliness

Answer 15

• Loneliness is the gap between the social interactions a person has and the connections they desire (Brehm et al., 2002).
• It can result from:
  
  • Social isolation (lack of social interactions)
  • Emotional isolation (lack of deep, meaningful connections)
• Women tend to experience loneliness due to social isolation (lack of social networks).
• Men are more likely to feel lonely due to emotional isolation (lack of deep, emotional bonds).
• Loneliness is often associated with low self-worth, impatience, desperation, and depression.

Question 16

older adult solitude

Answer 16

• Being alone does not always mean loneliness.
• Solitude is a positive experience where individuals:
  
  • Gain self-awareness
  • Focus on self-care
  • Feel comfortable being alone
    Pursue personal interests

Question 17

what are reproductive health conditions

Answer 17

• ‘Reproductive health conditions’ is a very broad term – these may also be called gynaecological conditions or women’s health conditions.
• Generally, this refers to medical conditions affecting the reproductive system.
• These can include (but are not limited to):
  
  • Endometriosis
  • Adenomyosis
  • Polycystic Ovary Syndrome (PCOS)
  • Uterine fibroids
    Gynaecologic cancer

Question 18

endometriosis: what is it?

Answer 18

• Endometriosis is a chronic gynaecological condition where endometrial-like tissue (the tissue lining the uterus) grows outside of the uterus and in other parts of the body (e.g., ovaries, fallopian tubes, bladder, bowel). This leads to chronic inflammation in the pelvis and around the body.
• Symptoms may include:
  
  • Chronic pelvic pain
  • Painful periods (dysmenorrhea)
  • Painful sex (dyspareunia)
  • Fatigue
  • Bloating
    Infertility

Question 19

endometriosis:prevalence and treatment

Answer 19

• It is estimated to affect one in ten women of reproductive age across the world (WHO, 2023), but it is estimated that as many as 60% of endometriosis cases are still undiagnosed (Ararwal et al., 2019)
• It takes an average of 10 years and at least 7 visits to a healthcare practitioner to receive a correct diagnosis (Fryer et al., 2024)
• There is no cure and treatment options are limited – generally focus on symptom control:
• Pain medication
• Hormone therapy (e.g., birth control, medical menopause)
• Surgery to remove endometriosis (laparoscopic excision is the current gold standard approach)
• Hysterectomy with removal of the ovaries
  Fertility treatment

Question 20

endometriosis: wellbeing

Answer 20

• Endometriosis poses significant challenges to one’s life, affecting physical health, employment, education, relationships, mental wellbeing and overall quality of life (Facchin et al., 2015; Van Barneveld et al., 2022)
• Associated with reduced quality of life and a heightened risk of depression and anxiety compared to the general population (Wang et al., 2021)
• Factors associated with impaired wellbeing and quality of life (Dempsey et al., 2022):
  
  • Symptoms
  • Diagnostic delay
  • Dismissal of symptoms
  • Not feeling believed
  • Lack of control
  • Uncertainty about the future
  • Lack of information on endometriosis
  • Stigma
    Lack of understanding from others

Question 21

despite the prevalence and impact of endometriosis…

Answer 21

• Public awareness of endometriosis is shockingly low
• New research from Endometriosis UK shows that…
• Endometriosis affects 1.5 million women and those assigned female at birth in the UK, similar to the number affected by diabetes or asthma
• 54% of people do not know what endometriosis is, increasing to 74% of men
• 62% of women between the age of 16-24 don’t know what endometriosis is
• 45% of women are unable to name any symptoms of the condition
• This shows a widespread lack of awareness for the condition, its symptoms and its impact

Question 22

friendships and endometriosis

Answer 22

• Friendships are generally an important source of social support throughout the lifecourse, but they can be challenging for people with endometriosis
• Symptoms (e.g., pain or bleeding) can prevent people with endometriosis from socialising – they often have to change or cancel their plans (Jones et al., 2009)
• Even when they do socialise, it can be difficult to fully engage due to constant worry about their symptoms flaring up
• Attending events can affect them for days after (e.g., fatigue or pain)
• Can become fearful of leaving their home
• Often have to prioritise certain activities (e.g., work) and sacrifice others (e.g., socialising)
• It can be difficult to talk to others about endometriosis as not everyone understands the condition - symptoms are often minimised or compared to a ‘normal’ period (Cole et al., 2020; Roomaney & Kagee, 2018)
• Many lose friends because they are unable to socialise:
  
  • They stop being invited to events
  • They are no longer included in texts
  • They are accused of making excuses
  • They feel stigmatised (e.g., by childlessness)
• As a result, people with endometriosis commonly report feeling lonely and isolated (Dempsey, 2022)
• They generally feel like they are to blame for the loss of friendships so are more likely to accept their social isolation (Cole et al., 2020)
  However, friendships can still be beneficial if friends have an understanding of endometriosis or are willing to learn (Varney, 2020)

Question 23

family relationships and endometriosis

Answer 23

• People with endometriosis may rely on family members for practical support (e.g., personal care) and emotional support (e.g., being a listening ear) (Wren & Mercer, 2022)
• Support can be well-intentioned but also unhelpful and frustrating (Varney, 2020):
  
  • “I hope you feel better soon”
  • Trying to fix the problem
  • Offering uninformed advice or solutions
• Familial relationships can be distressing when support isn’t provided or when relatives don’t accept or understand the condition (Moradi et al., 2014)
• Believe they are faking or exaggerating their pain/symptoms
• Referring to a family history of gynaecological problems and that other relatives ‘just get on with it’
• Not talking about endometriosis or menstrual symptoms – stigmatised topic
• Perceived negative reactions from family members can lead to the normalisation of symptoms, delayed help seeking, feelings of embarrassment and shame, and increased isolation (Karavadra, 2021)
• Endometriosis may also cause disruption or damage to the parent-child relationship:
• Can affect ability to care for or play with children when in pain
• Parents don’t want their children to see them in pain or suffering so may hide their symptoms – children are often aware of what is going on but know it isn’t spoken about
• Can experience a role reversal with children taking care of the parent
• For adolescents with endometriosis symptoms, parents have perceived control over bodily autonomy

Question 24

other types of relationships and endometriosis

Answer 24

• Work relationships:
  
  • Work relationships can be beneficial and may help people to cope with endometriosis, but only if they feel supported at work – dependent on work environment (Roomaney & Kagee, 2018)
  • Absenteeism (common experience with endometriosis) can lead to compromised social relationships with work peers (Nnoaham et al., 2011)
  • Many choose to “put a brave face on” due to fear of being judged negatively so limit what they share with colleagues - surface-level relationship
• Online relationships:
  
  • Often an important source of support, particularly for those who lack support offline (Varney, 2020)
  • E.g., Facebook pages help to reduce feelings of loneliness and provide the opportunity to be part of a bigger community who understand each other’s experience.
    Generally positive, but can increase feelings of anxiety and uncertainty when exposed to other, potentially more severe, experiences (Wren & Mercer, 2022)

Question 25

endometriosis- relationships with themselves

Answer 25

- Endometriosis can negatively impact a person's relationship with themselves in many ways: - Sense of identity – as a woman, mother, partner, friend, colleague (Osborne, 2008) - Trying to live up to norms and expectations from society and others - Self-esteem and self-confidence (Clark, 2012) - Comparing themselves to others can lead to feelings of abnormality and worthlessness - Often adopt negative perceptions of themselves if exposed to repetitive negative experiences - Body image (Calvi et al., 2023) - Guilt, shame and self-blame (Fuchsia Howard et al., 2024) Often feel like a burden (Dempsey, 2022)

Question 26

sex and intimacy with endometriosis

Answer 26

- The “we-disease” (Facchin et al., 2021) - People with endometriosis often experience disruption to sexual relationships - Pain during and after sex (dyspareunia) - Feeling unattractive or unfeminine - Loss of desire and libido - Many partners are hesitant to initiate or engage in sexual activity for fear of causing pain (McKay et al., 2022) - In many couples with endometriosis, sex is reported to be non-existent or rare - avoided due to pain or anticipation of pain. For others, they continue to have sex regardless of pain – they “push through” (Karavadra, 2021) Significant loss of other forms of intimacy, closeness and affection (e.g., cuddling) as for some, the pain means they don’t want to be touched – partners often feel distant from each other (Law et al., 2022)

Question 27

endometriosis and infertility

Answer 27

- Societal norms position parenthood as a normal and expected life event, but infertility is common for couples with endometriosis - Sex often becomes a chore that you do in the fertile period – no longer about romance or intimacy (Heng et al., 2022 - Significant psychological impact for both partners (Law et al., 2024; Schick et al., 2022) - Loss, grief, distress, failure - Fear of the future – anxiety - Pressure within families and societies to have children - Forced into early family planning – disrupted life trajectories Often have to choose between having children and being in pain – this can cause tension and arguments in a relationship if partners have different priorities (Clark, 2012)

Question 28

daily challenges with endometriosis

Answer 28

- The disabling and unpredictable nature of endometriosis impacts couples ability to take part in and enjoy activities outside of the home (e.g., dates, socialising, shopping) (Dempsey, 2022) - People with endometriosis are often unable to work full-time and/or may need to take regular time off – this can result in a reduced household income and increased financial strain for couples (Culley et al., 2013) - Can alter the balance of the relationship with increased dependency on partners - Increased pressure for partner to earn and provide - Communicating about how each partner feels about the impact of endometriosis (Law et al., 2024) - Without this, partners are left to guess how each other feels – behaviours are open to misinterpretation - Miscommunication and non-communication often results in tension, arguments, distress, and subsequent relationship breakdown - Important for dyadic coping Communication can also be a form of intimacy

Question 29

endometriosis- impact on the partner

Answer 29

- Endometriosis not only affects the person with the condition, but also their partner – remember the “we-disease” (Facchin et al., 2021) - Significant negative impact on wellbeing and quality of life (Ameratunga et al., 2017; Schick et al., 2022) - Psychological impact – e.g., feelings of helplessness and powerlessness from seeing their partner in pain and not being able to help - Emotional distress from infertility - Impaired social life – e.g., prefer to stay in with partner rather than leaving them alone - Increased day to day responsibility – e.g., more household chores, caring responsibilities for partner and/or children, increased financial/work pressure * Sometimes an unmanageable workload for partners without endometriosis Despite this impact, many partners tend to prioritise their partner’s wellbeing above their own needs (Culley et al., 2017)

Question 30

endometriosis and romantic relationships- positive elements

Answer 30

- The negative experiences of endometriosis can bring partners closer together (Hudson et al., 2016): - Facing challenges together - Opportunity for growth for both partners - Increased appreciation and understanding of one another - Strengthened relationship - Realisation of how much the other person means to you Whilst couples with endometriosis face significant challenges, relationships can still be positive and joyful experiences for both partners

Question 31

issues with relational research

Answer 31

- Very limited literature looking at the impact of endometriosis on couples/relationships - Research has so far focused on heterosexual couples in WEIRD populations - What does exist is mainly focused on how endometriosis impacts sex and intimacy - What about other ways in which endometriosis impacts relationships? - Common to conduct dyadic interviews (couples are interviewed together) - Problematic as partners may be less open about how endometriosis impacts them - Partners without endometriosis often let the person with endometriosis answer questions No research to date looking specifically at the impact of endometriosis on other types of relationships (e.g., friends or family)

Question 32

endometriosis- how can we improve things for couples?

Answer 32

- Increased education and awareness of endometriosis in society - Offer psychosocial support for couples - Offer psychosocial support for partners of those with endometriosis - Involve partners in endometriosis care and diagnosis Conduct more research into the impact of endometriosis on couples and partners