Endometriosis-associated Pain in Patients with and without Hormone Therapy

Abstract

Introduction

Endometriosis is associated with both cyclic and non-cyclic pelvic pain. Many patients do not remain symptom free, even after guideline-oriented treatment. This study aimed to identify differences in endometriosis-associated pain and test for possible associations with hormone therapy.

Methods

The results presented here are based on a cross-sectional study conducted at the Charité Endometriosis Center in Berlin in which pain profile data were collected via a questionnaire from women with a confirmed diagnosis of endometriosis. The questionnaire contained items concerning cyclic and non-cyclic pain, pain intensity, and pain duration. SPSS software was used to perform the statistical analysis, including descriptive and analytical statistics.

Results

Of 239 women surveyed, 121 (50.6%) reported current hormone therapy, and 185 (77.4%) reported previous hormone therapy. Moreover, 84% had current (cyclic and non-cyclic) pain symptoms, which were severe enough to warrant treatment in nearly 70% of all cases. Hormone therapy was only found to be associated with a slight, non-significant advantage in patients with “cyclic pain”. The reverse was true of non-cyclic pain: women on hormone therapy reported a greater incidence of pain, greater pain intensity, more frequent need for treatment, and more pain days.

Conclusions

With a very broad interpretation of our findings, it can be concluded that hormone therapy achieves some degree of pain reduction via down-regulation of the ovarian cycle, at least in the case of cyclic pain, whereas non-cyclic pain does not respond or no longer responds to hormones.