Evaluation of the characteristics of ovarian endometrioma in patients with endometriosis: efficacy of a low-dose estrogen/progestogen combination

Objectives: Approximately 17-44% of women diagnosed with endometriosis have ovarian endometriomas (cysts). Although ovarian endometriomas may adversely affect quality of life and work performance, no reports have been published on the relationship between patient characteristics, cyst size, and pain associated with ovarian endometriomas. The objective of this study was to assess the association between age, cyst size, and pain in women with ovarian endometriomas. Design: Retrospective secondary analysis of pooled data from six randomized clinical trials of the use of low-dose estrogen/progestogen drugs for endometriosis. Participants/Materials, Setting, Methods: Data on 491 patients enrolled in four randomized and two non-randomized trials between 2003 and 2017, who had not undergone surgical treatment prior to trial participation, were pooled. We examined differences in the dysmenorrhea score, menstrual pain score, analgesic score, and visual analog scale (VAS) by age and endometrioma size. Results The mean dysmenorrhea, menstrual pain, and analgesic scores were 4.2, 2.2, and 2.0, respectively. The mean VAS for pelvic pain was 55, which decreased significantly with increasing age. There was no correlation between age and endometrioma size, the dysmenorrhea score and the endometrioma volume or maximum diameter. In addition, there was no correlation between menstrual pain, analgesic score, or VAS and the endometrioma volume or maximum diameter. Limitations The details of past treatment history were not available; therefore, these could not be considered in the analysis. In addition, the assessment of pain is heavily influenced by psychological aspects, making it difficult to assess the true extent of pain. Conclusions Endometrioma size was unrelated to dysmenorrhea or pelvic pain measured using the VAS.