Analysis of Risk Factors Associated With Persistent Noncyclic Pelvic Pain Despite Hormonal Treatment in Patients With Endometriosis.
Matsuzaki. Sachiko S; Pouly. Jean-Luc JL; Canis. Michel M
Key Findings
- Having an ovarian endometrioma raises the odds of persistent pain about four‑fold (OR ≈ 4.1).
- Non‑cyclical chronic pelvic pain is a strong predictor of ongoing pain (OR up to 12 for VAS ≤60).
- Severe dyspareunia and a history of cesarean section also significantly increase the risk of pain that doesn’t improve with hormonal therapy.
Practical Outcomes
- For the biohacker community, this research offers little direct guidance. It suggests that GnRH‑based treatments like gonadorelin may not be sufficient for certain endometriosis patients, so alternative or adjunct strategies would be needed for pain management.
Summary
A study of 164 women with deep endometriosis found that those who have ovarian endometrioma, ongoing pelvic pain, severe pain during sex, or a previous C‑section are far more likely to keep feeling pain even after taking hormone medicines like GnRH agonists, progestins, or birth‑control pills.
Abstract
To identify risk factors that predict the persistence of noncyclical pelvic pain in patients with endometriosis despite receiving hormone therapy. This retrospective study examined 164 patients with histopathologically confirmed deep infiltrating endometriosis (DE) and/or ovarian endometrioma (OV). Clinical data obtained through preoperative face-to-face interviews were analyzed to identify risk factors for persistent pain despite receiving hormonal treatment (defined as visual analog-scale score [VAS] score > 30). All patients received preoperative hormonal treatment with progestins, combined oral contraceptives, or gonadotropin-releasing hormone agonists for at least three months prior to surgery. Multivariable analysis identified several risk factors: OV (odds ratio [OR]: 4.11, 95% confidence interval [CI]: 1.67-10.1, <i>p</i> = 0.002) versus no OV, noncyclical chronic pelvic pain (VAS score ≤ 60: OR: 12.0, 95% CI: 4.17-34.6; VAS score > 60: OR: 7.03, 95% CI: 2.25-21.9, <i>p</i> < 0.001) versus no pain, severe dyspareunia (VAS score > 60) (OR: 6.73, 95% CI: 4.17-34.6, <i>p</i> = 0.002) versus no dyspareunia, and a previous cesarean section (OR: 9.53, 95% CI: 1.54-59.0, <i>p</i> = 0.02) versus no previous cesarean section. Patients with ovarian endometrioma, noncyclical chronic pelvic pain, severe dyspareunia, and a history of cesarean section are at an increased risk for persistent pain despite hormonal treatment.
Study Information
pubmed
2025
2025-11-09T00:00:00.000Z
10.1002/rmb2.12684
27