The Long-Term Footprint of Endometriosis : Population-Based Cohort Analysis Reveals Increased Pain Symptoms and Decreased Pain Tolerance at Age 46 Years

• Published in: The Journal of Pain
• Main Authors: Vuontisjarvi, Saara, Rossi, Henna-Riikka, Herrala, Sauli, Morin-Papunen, Laure, Tapanainen, Juha S., Karjula, Salla, Karppinen, Jaro, Auvinen, Juha, Piltonen, Terhi T.
• Other Authors: Reproductive Disease Modeling, Department of Obstetrics and Gynecology, Clinicum, University of Helsinki, HUS Gynecology and Obstetrics
• Format: Article in Journal/Newspaper
• Language: English
• Published: Churchill Livingstone 2019
• Subjects: Endometriosis; pain threshold; pain tolerance; premenopause; CHRONIC PELVIC PAIN; QUALITY-OF-LIFE; PRESSURE PAIN; WOMEN; SENSITIVITY; DISORDERS; SENSITIZATION; PATHOGENESIS; MECHANISMS; IMPACT; 3112 Neurosciences; 3124 Neurology and psychiatry; 3123 Gynaecology and paediatrics; Northern Finland
• Online Access: http://hdl.handle.net/10138/299818

Previous studies have shown increased pain sensitivity in fertile-aged women with endometriosis in response to mechanical stimuli. As yet, population-based studies on the association of endometriosis with pain sensation and pain symptoms in late fertile age are lacking. The main objective of this population-based cohort study was to investigate whether a history of endometriosis is associated with altered pain sensation and musculoskeletal pain symptoms at age 46 years. Our data are derived from the Northern Finland Birth Cohort 1966, which contains postal questionnaire data (72% response rate) as well as clinical data assessing pressure-pain threshold and maximal pain tolerance. The study population consisted of 284 women with endometriosis and 3,390 controls. Our results showed that at age 46 women with a history of endometriosis had a 5.3% lower pressure-pain threshold and 5.1% lower maximal pain tolerance compared with controls. The most significant contributors besides endometriosis were anxiety, depression, and current smoking status. Women with endometriosis also reported an increased number of pain sites (0 pain sites, 9.6 vs 17.9%; 5-8 pain sites, 24.8 vs 19.1%, endometriosis vs controls respectively; P Perspective: This population-based cohort study showed decreased pain threshold and maximal pain tolerance in women with endometriosis in the late fertile age of 46 years. The pain was also found to be more bothersome and intense compared with controls. (C) 2018 by the American Pain Society Peer reviewed