Endometriosis-related pain: Are there specific strategies women uses to manage dysmenorrhea, chronic pelvic pain, dyspareunia, and dyschesia? A qualitative-questionnaire study.

Introduction. Endometriosis is a systemic disease that affects 10 to 15% of women in their reproductive age that leads to pain through complex interactions. Pain symptoms include dysmenorrhea, dyspareunia, dyschesia, chronic pelvic pain, and other comorbid chronic pain conditions, making pain management challenging. Objective. This study aimed to explore strategies used to manage pain, including dysmenorrhea, dyspareunia, dyschesia, and chronic pelvic pain. Methods. A large qualitative study involving 303 women diagnosed with endometriosis involved an online survey with open-ended questions to collect data on pain management. Thematic content analysis was conducted, and multidisciplinary debriefing meetings ensured method validity. Results. Overall, women experienced a feeling of helplessness and consulted healthcare professional. Dysmenorrhea and chronic pelvic pain showed similar patterns, with a basic combination of heat, analgesics and rest. Dyspareunia involved communication, avoidance, and social skills with partners. Dyschesia involved dietary changes and laxatives. Discussion. The overall sense of helplessness and lack of solution may be the result of insufficient information given post diagnosis. It could also reflect the way pain is formulated. We suggest that a switch from a symptom focus to a broader transactional one could help us reach a more comprehensive understanding of how women adjust to pain. Keywords: Endometriosis; Pain; Women’s health; Pain management; Global care; Quality of life