Mid-Cycle Pain in Endometriosis: Clinical Correlations and Potential Etiological Factors

Hannah E Rojas, Rojas HE, Jerilynn C Prior, Prior JC, Noga H, Heather Noga, Christina Williams, Williams C, M A Bedaiwy, Bedaiwy MA, Mohamed A Bedaiwy, Lee CE, Caroline E Lee, Allaire C, Catherine Allaire, C Allaire, Paul J. Yong, P J Yong
Journal of women's health (2002) · 2026 · vol. 35(8) , pp. 790–799 · doi:10.1177/15409996261443813 · PMID:42026880 · W7155568027
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⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

This study found that most endometriosis patients reported mid-cycle pain, associated with central sensitization, but not with anatomical distortion from the disease.

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The paper investigates mid-cycle pain in people with endometriosis and examines clinical correlations and possible etiological factors, using a study design focused on characterizing timing of pain relative to the menstrual cycle and relating it to patient and disease features. The key findings identify associations between mid-cycle pain and specific clinical variables, alongside hypotheses about mechanisms that could account for pain occurring around ovulatory or other mid-cycle events. The paper’s main limitation, as implied by its observational clinical correlation approach, is that it cannot definitively establish causation for the proposed etiological factors. This paper is centrally about endometriosis — it focuses specifically on mid-cycle pain and its clinical correlates and potential causes.

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Abstract

OBJECTIVE: To characterize differences between individuals with and without mid-cycle pain in a registry cohort with endometriosis. DESIGN: Prospective analysis of data from the Endometriosis Pelvic Pain Interdisciplinary Cohort Data Registry (Clinicaltrials.gov #NCT02911090) at a tertiary referral center in Western Canada. SUBJECTS: Three hundred forty-five individuals aged 18-49 years who: (1) had at least one episode of menstrual bleeding in the last 3 months, (2) attended a baseline initial visit, and (3) subsequently had surgery with histological confirmation of endometriosis between January 2018 and December 2023. Exclusion criteria included (1) previous hysterectomy; (2) hormonal suppressive therapy use in the last 3 months; and (3) missing data on mid-cycle pain, history of hormonal therapy use, or menstrual cycle regularity. EXPOSURES: N/A. MAIN OUTCOME MEASURES: Mid-cycle pain in the last month versus No mid-cycle pain in the last month. RESULTS: Of the 345 participants, 67% (n = 232) reported mid-cycle pain in the last month. Mid-cycle pain in the last month was significantly associated with higher mean Central Sensitization Inventory score (48 ± 17 versus 36 ± 16, p < 0.001) and more months of prior hormonal suppressive therapy use (58 [14-120] versus 26 [0-109], p = 0.012). Abnormal anatomy at the time of surgery (e.g., endometrioma, ovarian adhesions) was not associated with mid-cycle pain in the last month. CONCLUSION: In this endometriosis cohort at a tertiary referral center, most participants reported mid-cycle pain in the last month, which was associated with central sensitization but was not clearly related to endometriosis anatomical distortion.
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Condition tags

endometriosisendometrioma

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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