Endometriosis: A Retrospective Analysis of Clinical Data from a Cohort of 4,083 Patients, With Focus on Symptoms

Abstract

Background: Endometriosis is an estrogen-dependent and chronic inflammatory gynecological disease due to the presence of ectopic endometrial tissue outside the uterine cavity. This disease affects approximately 10% of the female population. In spite of its relatively high prevalence, information about its pathogenesis, diagnosis, and therapy is not complete.

Patients and methods: We present a retrospective study performed on 4,083 patients with endometriosis, with a focus on symptoms. The archived data were analyzed investigating the distribution of symptoms among patients, the correlation of symptoms with the occupation of the patients, and finally the correlation with the other anamnestic data. Statistical associations between the data for all cases were then considered separately.

Results: Chronic fatigue syndrome and dyspareunia were confirmed as being among the main symptoms of endometriosis, together with bowel disorders. On the other hand, we registered a low occurrence of urinary disorders and even of chronic pelvic pain, which is usually considered among the main symptoms of endometriosis. We found an increase in incidence of symptoms starting from the age group 25-29 years up to 40-44 years and, subsequently, a significant decrease in the group aged 55-59 years. For all the symptoms analyzed, we found a higher incidence in employers, graduates and freelancers. Finally, we found a protective effect of the number of gestations on chronic fatigue syndrome.

Conclusion: This in-depth study on such a vast cohort of affected patients clarifies some important aspects on the complex symptomatology of this still enigmatic disease. In particular, the study highlights the symptoms most closely related to endometriosis which will help speed up the diagnostic process of patients suffering from this pathology.

Keywords: Endometriosis; adenomyosis; anxiety; bladder pain; bowel disorders; chronic fatigue; chronic pelvic pain; depression; stress.

Figure 1. Histograms showing the frequency of swollen abdomen, asthenia, dyspareunia, rectal pain, bowel dysfunction, migraine, ovulatory pain, chronic pelvic pain, cystitis, denial of typical symptoms, and bladder pain in patients by age class.

Figure 2. Histograms showing the distribution of symptoms of swollen abdomen, asthenia, dyspareunia, rectal pain, bowel dysfunction, migraine, ovulatory pain, chronic pelvic pain, cystitis, denial of typical symptoms, and bladder pain in patients by occupation.

Figure 2. Histograms showing the distribution of symptoms of swollen abdomen, asthenia, dyspareunia, rectal pain, bowel dysfunction, migraine, ovulatory pain, chronic pelvic pain, cystitis, denial of typical symptoms, and bladder pain in patients by occupation.