ORIGINAL RESEARCH article
Front. Med.
Sec. Obstetrics and Gynecology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1635960
Clinical Characteristics of Endometriosis with and without Dysmenorrhea Diagnosed by Laparoscopy
Provisionally accepted
- Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Objective: To delineate the clinical characteristics of endometriosis patients with dysmenorrhea and analyze the correlations between the presence, severity, duration of dysmenorrhea, and the disease severity of endometriosis. Methods: In this retrospective study, a total of 489 patients with endometriosis who underwent laparoscopic surgery or were diagnosed with endometriosis during surgery for benign ovarian tumors were enrolled. Patients were categorized into dysmenorrhea-positive and dysmenorrhea-negative groups based on symptom presence at diagnosis. Subgroup analyses were further performed within the dysmenorrhea group based on pain severity (mild/moderate/severe) and duration (years). The impact of dysmenorrhea on endometriosis severity was evaluated using clinical, surgical, and histopathological parameters. Results: The proportion of patients without dysmenorrhea was 29.4%,while the proportion of patients with dysmenorrhea is 70.6%. Patients with dysmenorrhea are younger, have significantly higher CA125 levels, and have a higher surgical stage. Patients with dysmenorrhea are more likely to have infertility and deep infiltrating nodules. Elevated CA125 levels and infiltrating nodules are independent risk factors for dysmenorrhea. CA125 levels and surgical staging significantly increase with the severity of dysmenorrhea.CA199 levels increased with dysmenorrhea duration but decreased in patients with >10 years of symptoms. The longer the duration of dysmenorrhea, the more patients with adenomyosis. Conclusion: The presence, severity, and prolonged duration of dysmenorrhea are strongly associated with advanced endometriosis, infertility, and adenomyosis. Young women with dysmenorrhea warrant heightened clinical suspicion for endometriosis to avoid delayed diagnosis.
Keywords: Laparoscopy, Dysmenorrhea, Endometriosis, rASRM, CA125
Received: 30 May 2025; Accepted: 06 Aug 2025.
Copyright: © 2025 Li, Li, Yang, Yang and Ye. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Qingjian Ye, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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