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Decrease of dysmenorrhoea with hormonal treatment is a marker of endometriosis severity.

Louis Marcellin1, Mathilde Bourdon1, Doriane Houdre2

  • 1Université Paris Cité, Faculté de Santé, Faculté de Médecine Paris Centre, Paris, France; Service de Gynécologie-Obstétrique II et de Médecine de la Reproduction, AP-HP, Centre Hospitalier Universitaire (CHU) Cochin, 75014, Paris, France; Department 'Development, Reproduction and Cancer', Institut Cochin, INSERM U1016, Paris, France.

Reproductive Biomedicine Online
|March 23, 2023
PubMed
Summary
This summary is machine-generated.

A decrease in painful periods after hormonal therapy in endometriosis patients indicates a more severe form of the disease. This finding helps identify the deep infiltrating endometriosis phenotype, suggesting a marker for disease severity.

Keywords:
complete surgerydysmenorrhoeaendometriosishormonal treatment

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Area of Science:

  • Gynecology
  • Surgical Pathology

Background:

  • Endometriosis is a chronic condition characterized by endometrial-like tissue outside the uterus, often causing severe dysmenorrhea.
  • Suppressing hormonal therapy is sometimes used to manage endometriosis symptoms before surgical intervention.

Purpose of the Study:

  • To investigate if reduced dysmenorrhea following hormonal therapy predicts the endometriosis phenotype and disease severity.
  • To determine if this pain relief is a marker for deep infiltrating endometriosis (DIE).

Main Methods:

  • Retrospective observational cohort study of 578 women with endometriosis and preoperative pain.
  • Analysis of dysmenorrhea relief after suppressive hormonal therapy before surgery.
  • Comparison of endometriosis phenotypes based on hormonal therapy response.

Main Results:

  • 88.2% of patients experienced reduced dysmenorrhea after hormonal therapy.
  • These patients showed a higher incidence of deep infiltrating endometriosis (DIE) intestinal lesions (45.7% vs 30.8%).
  • A decrease in dysmenorrhea was significantly associated with the severe DIE phenotype (adjusted OR 3.9).

Conclusions:

  • Reduced dysmenorrhea after suppressive hormonal therapy is a marker for the deep infiltrating endometriosis phenotype.
  • This symptom relief is associated with greater endometriosis disease severity.