Comparative analysis of pain characteristics in women with and without endometriosis

Lana Oren; Lijamol Thoppil; George Mkheidze; Yaron Meerzon; Salome Kaldani; Lela Tandashvili

doi:10.1530/endoabs.99.P152

Objective: Endometriosis is a condition marked by presence of endometrial tissue outside the uterus, causing inflammation, adhesions, and pelvic structural changes.¹ Despite its impact on women’s quality of life, endometriosis symptoms are viewed as nonspecific, overlapping with other gynecological diseases and are normalized ², all contributing to a long delay in diagnosis. This cross-sectional study aimed to address these issues by analysing distribution and intensity of chronic pain in laparoscopically confirmed endometriosis patients compared to other gynecological conditions and healthy controls. Compared the severity of cyclic pain between the three cohorts, explored correlations between rASRM staging and common endometriosis pain symptoms (cyclic pain, dyspareunia, dyschezia, and dysuria), and assessed the impact of lifestyle factors (coffee consumption, exercise intensity) on the intensity of chronic pain.

Methods: 237 participants were categorized into endometriosis (n=76), other gynecological conditions (n=60), and healthy controls (n=101). Participants provided data by completing a custom questionnaire, including an interactive body map for chronic pain localization.

Results: Women with endometriosis exhibited a higher chronic pain intensity and broader distribution compared to other gynecological conditions or healthy individuals, particularly in the abdomen, pubic, lower back, anterior thighs, and gluteal regions. Similarly, cyclic pain was significantly elevated in endometriosis compared to the other cohorts. Additionally, no significant correlation was found between rASRM staging and the severity of common endometriosis pain symptoms. Finally, lifestyle factors showed no clear associations with chronic pain severity in endometriosis patients.


	Chest	Abdomen	Pubic	Anterior Hands	Anterior legs	Upper back	Lower back	Gluteal	Posterior Hands	Posterior Legs
ANOVA p-value	0.0211	<0.0001	<0.0001	0.4768	<0.0001	0.0527	0.0164	0.0002	0.1191	0.0487
Endometriosis vs Other Gynecological conditions p-value	0.3870	0.0017	<0.0001	>0.9999	0.0010	>0.1085	0.0455	0.0036	>0.2894	0.9233
Endometriosis vs Healthy p-value	0.0166	<0.0001	<0.0001	>0.6713	<0.0001	>0.9999	0.0336	0.0003	0.1761	0.0433
Other Gynecological Conditions vs Healthy p-value	>0.9873	>0.9999	>0.2654	>0.9999	>0.9999	>0.0778	>0.9999	>0.9999	>0.9999	>0.6921

Conclusion: This study provides insights into the complex landscape of chronic pain in endometriosis, as it revealed higher pain intensities and distribution compared to other gynecological conditions. The findings contribute to a deeper understanding of pain patterns, diagnostic considerations and reconfirm the limitations of the rASRM classification system.

References: 1. Bulletti C, Coccia ME, Battistoni S, Borini A. Endometriosis and infertility. J Assist Reprod Genet 2010;27(8):441–7. 2. Surrey E, Soliman AM, Trenz H, Blauer-Peterson C, Sluis A. Impact of Endometriosis Diagnostic Delays on Healthcare Resource Utilization and Costs. Adv Ther 2020;37(3):1087–99.

Endocrine Abstracts

P152