Abstract
Endometriosis is a common, chronic inflammatory condition, thought to have a higher incidence in symptomatic women, yet, commonly associated symptoms do not always correlate with the presence or severity of disease and diagnosis requires surgery. We prospectively collected data and assessed symptomology and NMR spectroscopy-based metabolomics of 102 women undergoing laparoscopic sterilisation at a tertiary referral centre in a cross-sectional study. Twelve women were incidentally diagnosed with endometriosis (11.7%). According to the pre-operative questionnaire, presence and absence of many symptoms usually attributed to endometriosis were declared at similar frequencies in women with or without endometriosis. Women with endometriosis reported apparently more persistent heavy periods (50% vs 18.9%), prolonged periods (25% versus 7.8%) and problems conceiving (27.3% versus 9%) than those without endometriosis. NMR could not discern any distinguishable differences in the serum metabolome between those with and without endometriosis. Our paper highlights the complex symptomology experienced by women, regardless of a surgical diagnosis of endometriosis. Previous literature and the current study failed to identify clear, distinguishable symptoms or biomarkers pertinent to surgically confirmed endometriosis in the general population. Therefore, development of effective, non-invasive tests for identifying this heterogenous benign condition, endometriosis, is likely to be challenging.
Highlights
Endometriosis is an oestrogen-dependent chronic inflammatory condition affecting approximately 1 in 10 women of the general population and up to 1 in 2 with infertility [1,1 3 Vol.:(0123456789)Reproductive Sciences2]
Irritable bowel syndrome (IBS) and overactive bladder symptoms were apparently more frequent in the group of women without endometriosis whilst women in the group diagnosed with endometriosis complained of a history of fertility problems more commonly (Table 1)
When the patient-reported symptomatology was considered, most discerning symptoms that appeared to be preferentially associated with surgical detection of endometriosis were consistent pelvic pain throughout the month (8.3% vs 4.4%); persistent heavy (50% vs 18.9%) and prolonged periods (25% vs 7.8%); haematochezia with their periods (41.6% vs 12.2%); and persistent dyspareunia (33.4% vs 12.3%), which were all reported at higher rates by the women diagnosed with endometriosis as opposed to those
Summary
Endometriosis is an oestrogen-dependent chronic inflammatory condition affecting approximately 1 in 10 women of the general population and up to 1 in 2 with infertility [1,1 3 Vol.:(0123456789)Reproductive Sciences2]. Endometriosis is an oestrogen-dependent chronic inflammatory condition affecting approximately 1 in 10 women of the general population and up to 1 in 2 with infertility [1,. Women with endometriosis often suffer with dysmenorrhea as well as chronic pelvic pain and this can affect work, leisure, and social and intimate relationships [3]. Symptoms of pain, related to endometriosis, affect the psychological health of women, compromising their quality of sleep and contributing to anxiety and depression [3,4,5,6,7]. Despite the large number of studies conducted to date, noninvasive biomarker-based tests have not yet proven to be effective in diagnosing women with endometriosis in lowrisk populations. A non-invasive test in this population will help to understand the natural history of endometriosis and facilitate disease surveillance
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