Prevalence of Endometriosis and Its Symptoms among Young Jordanian Women with Chronic Pelvic Pain Refractory to Conventional Therapy

OBJECTIVE: This study sought to explore the prevalence and clinical manifestations of endometriosis in young women with chronic pelvic pain (CPP) refractory to conventional medical therapy. METHODS: This prospective clinical interventional study was conducted in two general and private hospitals in the city of Al-Karak in Jordan. A total of 28 female patients aged ≤21 who had CPP refractory to conventional medical therapy were recruited during the years 2010-2014. The intervention used in the study was laparoscopy. Endometriosis was staged according to the American Society for Reproductive Medicine classification. The main outcome measures were the presence and stage of endometriosis at laparoscopy, the presence of cold intolerance, and the severity and duration of pain symptoms. RESULTS: The mean age of participants was 18.4 (range 15 to 21). Endometriosis was found in 20 of 28 participants (71.4%), as follows: stage I, 9 of 20 (45.0%); stage II, 8 of 20 (40%); stage III, 2 of 21 (10%); and stage IV, 1 of 21 (5%). Notably, 16 of 28 (57.1%) of all participants reported cold intolerance, including 14 of 20 (70%) with endometriosis and 2 of 8 (25%) without endometriosis (Fisher exact [1-tail] P = 0.039). There was no association between stage of disease and age distribution (≤18 and >19 to 21; P = 0.7) or with duration of symptoms (≤2 and >2 years) and the presence of cold intolerance (P > 0.05). However, severity of pain symptoms (<7 vs. ≥7, as measured by the visual analogue scale [VAS]) was associated significantly with stage of disease (P = 0.011). CONCLUSION: The prevalence of endometriosis among young women with CPP refractory to conventional therapy was high, mainly in the mild stage. Cold intolerance was highly associated with endometriosis.