Subgroups of pelvic pain are differentially associated with endometriosis and inflammatory comorbidities: a latent class analysis

Marzieh Ghiasi, Chi Chang, Amy L Shafrir, Allison F Vitonis, Naoko Sasamoto, Ana I Vazquez, Ana I. Vázquez, Amy D DiVasta, Kristen Upson, Christine B Sieberg, Kathryn L Terry, Claudia B Holzman, Claudia Holzman, Stacey A Missmer
Pain · 2024 · vol. 165(9) , pp. 2119–2129 · doi:10.1097/j.pain.0000000000003218 · PMID:38563996 · W4393544360
article OA: green CC0 ⤵ 2 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

Latent class analysis identified five pelvic pain subgroups, with those experiencing more severe or acyclic pain exhibiting higher associations with endometriosis, migraines, and other inflammatory comorbidities.

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Abstract

ABSTRACT: Chronic pelvic pain is heterogeneous with potentially clinically informative subgroups. We aimed to identify subgroups of pelvic pain based on symptom patterns and investigate their associations with inflammatory and chronic pain-related comorbidities. Latent class analysis (LCA) identified subgroups of participants (n = 1255) from the Adolescence to Adulthood (A2A) cohort. Six participant characteristics were included in the LCA: severity, frequency, and impact on daily activities of both menstruation-associated (cyclic) and non-menstruation-associated (acyclic) pelvic pain. Three-step LCA quantified associations between LC subgroups, demographic and clinical variables, and 18 comorbidities (10 with prevalence ≥10%). Five subgroups were identified: none or minimal (23%), moderate cyclic only (28%), severe cyclic only (20%), moderate or severe acyclic plus moderate cyclic (9%), and severe acyclic plus severe cyclic (21%). Endometriosis prevalence within these 5 LCA-pelvic pain-defined subgroups ranged in size from 4% in "none or minimal pelvic pain" to 24%, 72%, 70%, and 94%, respectively, in the 4 pain subgroups, with statistically significant odds of membership only for the latter 3 subgroups. Migraines were associated with significant odds of membership in all 4 pelvic pain subgroups relative to those with no pelvic pain (adjusted odds ratios = 2.92-7.78), whereas back, joint, or leg pain each had significantly greater odds of membership in the latter 3 subgroups. Asthma or allergies had three times the odds of membership in the most severe pain group. Subgroups with elevated levels of cyclic or acyclic pain are associated with greater frequency of chronic overlapping pain conditions, suggesting an important role for central inflammatory and immunological mechanisms.

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Condition tags

mesh:D004715mesh:D017699endometriosischronic_pelvic_pain

MeSH descriptors

Comorbidity Comorbidity Comorbidity Comorbidity Comorbidity Comorbidity Comorbidity Comorbidity Comorbidity Comorbidity Comorbidity Comorbidity Comorbidity Comorbidity Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis

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References (67)

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europepmc
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openalex
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