The Long-Term Effect of Endometriosis

Women with endometriosis have a decreased pain tolerance even after fertile age and therefore require long-term treatment and psychological support

Key Points

Highlights:

Having had endometriosis reduces a woman’s tolerance to pain even beyond fertile age.

Importance:

Women with a history of endometriosis should be provided with adequate medical treatment and psychological support even after their fertile years.

What's done here:

Researchers from Finland analyzed data from 284 women with endometriosis and 3.390 without. 

Key results:

• Women age 46 who had a history of endometriosis have a 5.3 percent lower pressure pain tolerance and 5.1 percent lower maximal pain tolerance compared to women without a history of the disease. 
• Women with endometriosis have an increased number of pain sites and a more troublesome and intense pain compared to women without the disease. 
• Anxiety, depression, and smoking status also contribute to reduced pain tolerance.

Limitations of the study:

• Women analyzed in this study were identified from a single data set and were all of the same ethnicity so the results may not be applicable to other groups of women.
• The data included subjective questionnaire data as well as objective pain measurements.
• The data include self-reported endometriosis diagnosis without any clinical symptoms so it is possible that the control group also included women with endometriosis who have milder pain symptoms and /or sensitivity.  
• The clinical significance of the findings remains uncertain.
• The associations between endometriosis-related pain and pain related to other factors such as co-existing illnesses, menopause, or estradiol levels were not investigated during this study and should be further researched.

Lay Summary

Women with endometriosis have a decreased pain tolerance even after fertile age and therefore require long-term treatment and psychological support

Endometriosis has a long-term effect on the pain tolerance of women, suggests a study published in The Journal of Pain. It is therefore of great importance to provide these women with adequate psychological support and medical treatment even after their fertile years.

The findings also suggest that delaying the diagnosis of endometriosis may lead to increased pain sensitization. So diagnosing the condition as early as possible is of great importance to limit the occurrence of associated diseases.

The study that analyzed 284 women with endometriosis and 3,390 without showed that those with the disease had a decreased pain threshold and maximal pain tolerance even beyond fertile age. The study also found that the pain was more intense and occurred at more sites and more often in women with endometriosis compared to those without.

According to the authors, “…this is the first population-based study showing a decreased pain threshold and a decreased maximal pain response among women of late fertile age with a history of endometriosis”. 

It was already known that endometriosis increases pain sensitivity in women of fertile age. In order to investigate whether this increase persists beyond fertile age, researchers by Dr. Terhi Piltonen at Oulu University in Finland analyzed data about women, ages 46 from the Northern Finland Birth Cohort 1966.

They found that at age 46 women with a history of endometriosis had a 5.3 percent lower pressure pain tolerance and 5.1 percent lower maximal pain tolerance compared to those without a history of the disease. Women with endometriosis also reported an increased number of pain sites and a more troublesome and intense pain compared to those without the disease. 

Other factors contributing to decreased pain tolerance included anxiety, depression, and smoking status.

“This unique data revealed an altered pain sensation and a greater likelihood of reporting musculoskeletal pain at age 46 among women with a history of endometriosis,” the authors concluded. They added that these results “imply that endometriosis has a long-term footprint on affected women” emphasizing the need for continued medical treatment and psychological support.

Research Source: https://www.ncbi.nlm.nih.gov/pubmed/29496639