Features of the clinical picture and severity of pain syndrome in girls with genital endometriosis on the background of conservative therapy of the disease in adolescence

Abstract

Introduction. Endometriosis is characterised by a chronic course and significantly affects the quality of life of young patients. Aim. To study the features of the clinical picture and pain syndrome in adolescent girls with genital endometriosis against the background of 1 year of therapy.Materials and methods. A prospective longitudinal study included 32 girls (14–17 years old) with a confirmed diagnosis of genital endometriosis. The clinical picture and severity of pain syndrome were assessed against the background of conservative therapy with NSAID (naproxen) to relieve dysmenorrhea and gestagen (dienogest) for 1 year.Results. The main complaint of girls with endometriosis was pain, which appeared on the day before menstruation or in the middle of the cycle since menarche (64%) or increased in 1–1.5 years after menarche (23%) to very intense pain (8.3 ± 1.6 V scale) of a tensive (44%) or clutching (25%) nature. One third of adolescents reported daily pain (24%), the majority (75%) complained of restricted daily activity and performance, gastrointestinal symptoms (44%) and dysuria (22%). After 1 year of treatment with gestagens and NSAIDs patients had a significant decrease in pain on the days of menstruation (p <0,001), as well as outside menstruation (p <0,001), frequency of restriction of daily activities (p <0,001), weakness, lowered working capacity on menstrual days (p < 0.001), gastrointestinal symptoms (p < 0.001) and urinary disorders (p < 0.001) and the need for mandatory pain medication (p < 0.001).Conclusion. A significant reduction in pain syndrome and clinical manifestations of dysmenorrhea against the background of an improved quality of life was observed in the adolescent patients during 1 year of conservative endometriosis therapy. No intensification or increase in the frequency of headache attacks or significant changes in BMI were observed in the study group, which is indicative of good tolerance and contributes to treatment adherence in young female patients.