Association between Endometriosis, Dysmenorrhea, and Chronic Pelvic Pain in Women of Reproductive Age. A Clinical Study

Abstract

Background: Endometriosis is a chronic gynecological disorder characterized by the presence of endometrial tissue outside the uterine cavity and is a major cause of dysmenorrhea and chronic pelvic pain in women of reproductive age. Despite its high prevalence, it remains underdiagnosed, particularly in developing countries, leading to significant morbidity and reduced quality of life. The objective of this study was to evaluate the association between endometriosis, dysmenorrhea, and chronic pelvic pain.

Methods: This cross-sectional clinical study was conducted at Shalamar Hospital, Lahore, and Aziz Bhatti Shaheed Teaching Hospital, Gujrat, Pakistan, from January 2024 to June 2025. A total of 120 women aged 18–45 years presenting with pelvic pain or menstrual complaints were included using consecutive non-probability sampling. Diagnosis of endometriosis was based on clinical evaluation, ultrasound, and laparoscopy, where required. Severity of dysmenorrhea was assessed using the Visual Analog Scale (VAS), and chronic pelvic pain was defined as non-cyclic pain lasting more than six months. Data were analyzed using SPSS version 26, with p < 0.05 considered statistically significant.

Results: Endometriosis was diagnosed in 45.0% of participants. Severe dysmenorrhea was significantly more common in women with endometriosis (66.7%) compared to those without (27.3%) (p < 0.001). Chronic pelvic pain was reported in 72.2% of endometriosis patients versus 45.5% in non-endometriosis patients (p = 0.002). A strong positive correlation was observed between endometriosis and dysmenorrhea (r = 0.61) as well as chronic pelvic pain (r = 0.65).

Conclusion: Endometriosis is strongly associated with increased severity of dysmenorrhea and a higher prevalence of chronic pelvic pain. Early clinical suspicion and timely diagnosis are essential for effective management and improved quality of life in affected women.