VP62.33: Effect of hormonal treatment on dyspareunia in women with and without endometriosis

The aim is to assess the effect of hormonal treatment on patients' symptoms in women with dyspareunia with regard to ultrasound findings. Women with dyspareunia and suspected endometriosis underwent ultrasound examination in 2014–2019 using GE E8 and E10 technique according to standardised endometriosis examination protocol. Women were asked about symptoms (dyspareunia, dysmenorrhoea, chronic pelvic pain, dyschezia, dysuria). Severity of symptoms was assessed using visual analogue scale (VAS). The severity of symptoms in women with and without hormonal treatment was compared in women with and without endometriosis. Out of 483 women with moderate to severe dyspareunia, 224 (46%) had normal ultrasound findings, 138 (29%) had visible endometriosis of any location on ultrasound examination and 121 (25%) had other pathological findings. Women with endometriosis reported lower VAS for dyspareunia than women without endometriosis in the group without hormonal treatment (56 (33–100) vs. 79 (15–100), p = 0.001, but no difference was found in women with hormonal treatment 59 (3–100) vs. 64 (2–100), p = ns). VAS was lower when women had hormonal treatment than no treatment in the absence of endometriosis findings (p < 0.01) but no difference was found between women with endometriosis. Hormonal treatment had no effect on dyspareunia when it was associated with ovarian endometrioma, deep endometriosis, adhesions, and obliteration of pouch of Douglas. It was reducing VAS values when none of these endometriosis features were present. Hormonal treatment significantly reduced VAS score for dyspareunia independently of presence or absence of infertility, previous abdominal or endometriosis related surgery, vaginal, cervical and adnexal tendernes, use of analgesics. Women with detected endometriosis had less severe dyspareunia than women without. It points out the existence of various pathogenesis of dyspareunia. Hormonal treatment does not reduce the dyspareunia as assessed by VAS score in women with any location of endometriosis.