Endocrine Abstracts

Introduction: Thoracic Endometriosis Syndrome (TES) is characterized by clinical symptoms associated with menstruation (eg, catamenial pneumothorax (CP), chest pain, and others) not obligatorily requiring histological confirmation. The treatment is burdened with frequent recurrences. This study aimed to characterize the treatment of women with TES and assess the concomitant diseases.

Methods: A developed online survey was published in patients’ support group. It consisted of sections regarding demographics, symptoms, various treatment strategies, infertility, vitamin D supplementation and diet.

Results: In this descriptive study 40 women with mean age of 37 (22-44y) were included, 85% had confirmed pelvic endometriosis. Eleven patients were diagnosed pathologically with thoracic endometriosis, while the rest (72.5%) experienced the symptoms of TES. 22.5% had a family history of endometriosis, and 1 of them confirmed that a family member had TES. 34 women (85%) were treated with hormonal therapy. 40% of women had comorbidities – the most prevalent were hypothyroidism (50%), insulin resistance(31.3%), asthma (25%), and nodular goitre (18.3%). Progestogens and combined oral contraceptives were the most commonly used, 74.5% and 35.3% respectively. GnRH agonists and among progestogens – dienogest were the most effective in control of recurrent CP (40% of 5 and 30.8% of 26 women). All hormonal drugs alleviated pain. 62.5% of women supplemented vitamin D, 12 of which had previously confirmed insufficiency. Those with insufficiency understandably had higher mean vitamin D dosage (3273 IU vs 2354 IU). Due to hormonal treatment, it was difficult to determine the independent influence of supplementation on symptoms, however, those without hormonal treatment did not notice any changes. 27 women had been pregnant, 7 of whom had miscarriages, but only 2 had not been able to become pregnant again. 35% of all women had been treated due to infertility. 57.5% changed their diet after the diagnosis – the most common changes were an anti-inflammatory diet, sugar withdrawal, and red meat withdrawal. 6 patients had not used hormonal therapy when they changed their diet – most of them did not notice any changes or symptoms appeared more often.

Conclusions: The most prevalent comorbidity with TES is hypothyroidism. The most effective treatment strategies are GnRH agonists and progestogens. All hormonal drugs alleviate pain in TES. Vitamin D supplementation did not change the course of the disease. Infertility is common among TES patients.