Abstract
Endometriosis is a progressive estrogen-dependent disease affecting women during their reproductive years. The objective of the present study was to investigate whether endometriosis is associated with stress parameters. We determined cortisol and prolactin levels in serum, peritoneal and follicular fluid from infertile women with endometriosis and fertile women without the disease. The extent of the disease was staged according to the revised American Fertility Society classification (1997). Serum and peritoneal fluid were collected from 49 women aged 19 to 39 years undergoing laparoscopy. Eighteen women had stage I-II endometriosis and 10 had stage III-IV. Controls were 21 women undergoing laparoscopy for tubal sterilization. Follicular fluid was obtained from 39 women aged 25-39 years undergoing in vitro fertilization (21 infertile women with endometriosis and 18 infertile women without endometriosis). Serum prolactin levels were significantly higher in infertile women with stage III-IV endometriosis (28.9 +/- 2.1 ng/mL) than in healthy controls (13.2 +/- 2.1 ng/mL). Serum cortisol levels were significantly higher in infertile women with stage III-IV endometriosis (20.1 +/- 1.3 ng/mL) than in controls (10.5 +/- 1.4 ng/mL). Cortisol and prolactin levels in follicular fluid and peritoneal fluid did not differ significantly between groups. The high levels of cortisol and prolactin in the serum from women with endometriosis might contribute to the subfertility frequently associated with the disease. Moreover, since higher levels of cortisol and prolactin are often associated with stress, it is probable that stress might contribute to the development of endometriosis and its progression to advanced stages of the disease.
Highlights
Endometriosis is a clinically insidious disease, being one of the most common benign diseases affecting women of reproductive age
Among the hormonal alterations associated with the endometriosis, hyperprolactinemia is one of the conditions most frequently mentioned in the literature
Many researchers have investigated the relation between serum prolactin levels and infertility in patients with endometriosis, but the results are controversial
Summary
Endometriosis is a clinically insidious disease, being one of the most common benign diseases affecting women of reproductive age. It is characterized by the presence and growth of ectopic endometrial tissue outside the endometrial cavity. This complex disease is a common gynecologic problem frequently associated with infertility and pelvic pain [1]. Endometriosis, endometriosis-associated reproductive failure and idiopathic infertility are still among the most difficult problems facing the gynecologist. A significant number of women who complain of dysmenorrhea and pelvic pain have endometriosis, and more than 50% of women with unexplained infertility are diagnosed with endometriosis by laparoscopy. The incidence of endometriosis seems to be increasing [2,3,4]
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