Pain Levels of Women Diagnosed with Endometriosis: Is There a Difference in Younger Women?

STUDY OBJECTIVE: Early diagnosis and treatment of endometriosis affecting adolescent women are important in preventing chronic pain. Our aim was to analyze the clinical characteristics and severity of symptoms in adolescent patients with endometriosis compared to older patients.

METHODS: This single-center retrospective cohort study in a tertiary referral hospital analyzed women whose first consultation at the certified endometriosis center of the Bern University Hospital between January 2017 and December 2020 resulted in the clinical diagnosis of endometriosis. Patients, divided into 2 groups by age, reported Visual Analog Scale (VAS) scores for non-cyclic pelvic pain, dysmenorrhea, dyschezia, dysuria, and dyspareunia. The symptom types and severity in the two groups were compared. The young patients with endometriosis were analyzed in greater detail, comparing VAS scores and types of endometriosis.

RESULTS: From a total of 826 patients, 144 (17.4%) patients aged ≤24 years old and 682 (82.6%) patients aged >24 years old were compared. The younger patients reported significantly higher pain scores for dysmenorrhea (VAS 7.3 vs. VAS 6.6, p= 0.015), dyspareunia (VAS 4.6 vs. VAS 3.4, p= 0.001), and non-cyclic pelvic pain (VAS 4.3 vs. 3.7, p= 0.032) compared to the older patient collective. Similar results were found when excluding patients with hormonal treatment.

CONCLUSION: Young patients with clinically diagnosed endometriosis have significantly higher dysmenorrhea and dyspareunia pain levels than older patients. By acknowledging and understanding this, early diagnosis and adequate treatment can be promoted. Dyspareunia in adolescents in particular merits clinical attention.