Perfil das Pacientes com Dor Pélvica Crônica e Endometriose em São Luis do Maranhão

Abstract

Introduction: Chronic pelvic pain associated with endometriosis is a frequent, multifactorial, and debilitating condition that compromises quality of life, functional performance, and reproductive health. Despite its clinical relevance, there are still few national studies that comprehensively describe the clinical, epidemiological, and psychosocial profile of these patients, as well as the overlap of comorbidities and central pain sensitization mechanisms. Objective: To outline the sociodemographic, reproductive, clinical, and psychosocial profile of women with chronic pelvic pain treated at a high-complexity hospital in São Luís, Maranhão, comparing those with and without endometriosis, and characterizing the intensity, mechanisms, and pain centralization. Methods: This was a prospective, analytical, observational study with a quantitative approach, conducted in the gynecology outpatient clinic of a highcomplexity hospital in São Luís, Maranhão, Brazil, between August 2022 and July 2025. Participants included women ≥18 years old with chronic pelvic pain who underwent investigation with imaging exams and/or videolaparoscopy for the diagnosis of endometriosis. Results: A total of 174 women were included, with a prevalence of endometriosis of 67.2%. Among patients with endometriosis, deep endometriosis in the uterosacral ligaments was observed in 50.5%, with 45.5% in stages 3-4 of the disease. Women with endometriosis had higher levels of education and a higher rate of nulliparity. Dysmenorrhea was widely present among women with endometriosis, while painful and functional comorbidities showed high frequencies in both groups, such as migraine, irritable bowel syndrome, myofascial pain, vulvodynia, and neuropathic pain. Pain centralization showed a predominant distribution of severe to extreme degrees, and most women exhibited symptoms of depression, anxiety, and stress of varying intensities, mainly extremely severe anxiety in 31.3% of patients with endometriosis and 41.9% of those without the disease. Conclusion: Chronic pelvic pain associated with endometriosis is characterized by a strong relationship with dysmenorrhea and nulliparity, as well as an overlap of painful comorbidities and psychological distress.