MEDICAL-SOCIAL AUDIT OF REPRODUCTIVE AGE WOMEN WITH OVARIAN ENDOMETRIOMAS

O.А. Dyndar, O.Z. Dymarska
In: Medical Science of Ukraine (MSU) · 2024 · vol. 20(1) , pp. 4–11 · doi:10.32345/2664-4738.1.2024.01 · W4393357729
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⚙ AI-generated summary by claude@2026-06, 2026-06-11 ⓘ

This study examined clinical and anamnestic features in 120 reproductive-aged women with ovarian endometriomas, identifying common complaints, menstrual irregularities, and associated gynecological pathologies.

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The paper studied the clinical and anamnestic features of 120 reproductive-aged women with ovarian endometriomas, compared with 30 women without gynecologic pathology, using a specially designed 300-question questionnaire and clinical/medical history assessment. The authors report that women with ovarian endometriomas commonly had dragging lower abdominal pain (82.5%), menstrual disturbances (95.8%), and dysmenorrhea/hypermenorrhea (86.7%/73.3%), with associated dyspareunia (26.7%) and infertility (primary 30.8%, secondary 19.2%); they also found early menarche in 48.3% and dysregulated or abnormal uterine bleeding patterns. A major caveat is that the work is based on retrospective/clinical self-reported and recorded history rather than mechanistic measures. Endometriomas in 13.3% were combined with adenomyosis, indicating overlap; this paper is centrally about endometriosis — specifically ovarian endometriomas and their clinical associations with menstrual/reproductive histories and comorbid adenomyosis.

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Abstract

Background. Ovarian endometriomas account for 35% of all benign ovarian cysts and are identified in 17-44% of women with endometriosis. External genital endometriosis is diagnosed in 10-15% of women in the general population, 25-60% of patients with infertility, 80% of those with pelvic pain syndrome, and in cases of dysmenorrhea, it ranges from 40 to 60%. Priority issues include early diagnosis, management tactics, and preservation of ovarian reserve in women with ovarian endometriomas. However, risk factors contributing to the formation and progression of the disease are nonspecific, and the clinical presentation does not always correspond to the severity of the condition. Aim. To determine the clinical and anamnestic features of women of reproductive age with ovarian endometriomas. Materials and methods. A clinical and anamnestic examination was conducted on 120 reproductive-aged patients with ovarian endometriomas (main group) and 30 women without gynecological pathology (control group). The average age of the examined individuals was 29.5±1.3 years. The examination protocol included the assessment of objective and subjective data recorded in a specially designed questionnaire containing 300 questions. Statistical data analysis was performed using the computer program "Statisticа 13.3.721." Results. The main complaints of examined women with ovarian endometriomas include a dragging pain in the lower abdomen (82.5%), menstrual cycle disturbances (95.8%), dyspareunia (26.7%), impairment of adjacent organ functions (10.8%), periovulatory pain (12.5%), primary (30.8%), and secondary (19.2%) infertility. Early menarche was found in 48.3% of women, and late menarche in 15.8%. Dysmenorrhea was observed in 86.7%, hypermenorrhea in 73.3%, and acyclic bloody discharges in 12.5%. From the gynecological history, there is a 3.8 times higher frequency of inflammatory diseases of the appendages, a 4.1 times higher frequency of breast diseases, a 2.4 times higher frequency of abnormal uterine bleeding, a 2.3 times higher frequency of "functional" ovarian cysts and ovarian apoplexy. Endometriomas in 13.3% of patients were combined with adenomyosis, in 14.2% with uterine fibroids, and in 10.8% with intrauterine pathology. Conclusion. The analysis of clinical and anamnestic data of women with ovarian endometriomas revealed the main complaints at the time of admission to the hospital, previous and concomitant extragenital pathology, identified the family history, status of menstrual and reproductive function, and gynecological diseases.
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Abstract

Background. Ovarian endometriomas account for 35% of all benign ovarian cysts and are identified in 17-44% of women with endometriosis. External genital endometriosis is diagnosed in 10-15% of women in the general population, 25-60% of patients with infertility, 80% of those with pelvic pain syndrome, and in cases of dysmenorrhea, it ranges from 40 to 60%. Priority issues include early diagnosis, management tactics, and preservation of ovarian reserve in women with ovarian endometriomas. However, risk factors contributing to the formation and progression of the disease are nonspecific, and the clinical presentation does not always correspond to the severity of the condition. Aim. To determine the clinical and anamnestic features of women of reproductive age with ovarian endometriomas.

Materials

and methods. A clinical and anamnestic examination was conducted on 120 reproductive-aged patients with ovarian endometriomas (main group) and 30 women without gynecological pathology (control group). The average age of the examined individuals was 29.5±1.3 years. The examination protocol included the assessment of objective and subjective data recorded in a specially designed questionnaire containing 300 questions. Statistical data analysis was performed using the computer program "Statisticа 13.3.721." Results. The main complaints of examined women with ovarian endometriomas include a dragging pain in the lower abdomen (82.5%), menstrual cycle disturbances (95.8%), dyspareunia (26.7%), impairment of adjacent organ functions (10.8%), periovulatory pain (12.5%), primary (30.8%), and secondary (19.2%) infertility. Early menarche was found in 48.3% of women, and late menarche in 15.8%. Dysmenorrhea was observed in 86.7%, hypermenorrhea in 73.3%, and acyclic bloody discharges in 12.5%. From the gynecological history, there is a 3.8 times higher frequency of inflammatory diseases of the appendages, a 4.1 times higher frequency of breast diseases, a 2.4 times higher frequency of abnormal uterine bleeding, a 2.3 times higher frequency of "functional" ovarian cysts and ovarian apoplexy. Endometriomas in 13.3% of patients were combined with adenomyosis, in 14.2% with uterine fibroids, and in 10.8% with intrauterine pathology. Conclusion. The analysis of clinical and anamnestic data of women with ovarian endometriomas revealed the main complaints at the time of admission to the hospital, previous and concomitant extragenital pathology, identified the family history, status of menstrual and reproductive function, and gynecological diseases.

References

Zondervan KT, Becker CM, Koga K, Missmer SA, Taylor RN, Viganò P. [Endometriosis.NatRev Dis Primers]. 2018; 4 (1): 9. DOI:10.1038/s41572-018- 0008-5. Gruber TM, Mechsner S. [Pathogenesis of Endometriosis: The Origin of Pain and Subfertility]. Cells. 2021; 10 (6): 1381. DOI: 10.3390/cells10061381 Pakharenko LV, Basiuha IO, Zhurakivskyi VM, Lasytchuk OM, Kurtash NYа. [The importance of the microflora of the genital tract in the development of endometriosis]. Women's reproductive health .2023; (2): 21–25. [In Ukrainian]. DOI:10.30841/2708-8731.2.2023.278155 . Symons LK, Miller JE, Kay VR, Marks RM, Liblik K, Koti M, et al. [The Immunopathophysiology of Endometriosis]. Trends Mol Med. 2018; 24 (9): 748- 62. DOI: 10.1016/j.molmed.2018.07.004. Tolstanova G [A differentiated approach to the treatment of external genital endometriosis as a prevention of relapses, a woman's productive health]. Women's reproductive health. 2022;(2):66–72. [In Ukrainian]. DOI:10.30841/2708-8731.2.2022.261813. Prescott J et al. A prospective cohort study of endometriosis and subsequent risk of infertility. Hum. Reprod. 2016. 31: 1475-1482. DOI: 10.1093/humrep/dew085 Farland L. V. et al. Associations among body size across the life course, adult height and endometriosis. Hum. Reprod. 2017; 32: 1732-1742. DOI: 10.1093/humrep/dex207. Medvedyev MV, Pokrovenko DA. [A modern view of the etiology, pathogenesis and diagnostic possibilities of external genital endometrios]. Cited: Medicni perspektivi. 2019; 24 (1): 21-30. [In Ukrainian]. DOI:10.30841/2708-8731.2.2022.261813. Derzhavnyy ekspertnyy tsentr MOZ Ukrayiny IOZU https://www.dec.gov.ua › mtd. Unifikovanyy klinichnyy protokol pervynnoyi, vtorynnoyi (spetsializovanoyi) ta tretynnoyi (vysokospetsializovanoyi) medychnoyi dopomohy. Taktyka vedennya patsiyentok z henitalʹnym endometriozom. Genital endometriosis. Available on: https://www.dec.gov.ua/mtd/genitalnyj-endometrioz/ Веniuk VO, Dyndar OA, Usevich IA, Govseev DO, Honcharenko VM, Kovaluk TV, Hychka NM [Alhorytmy v akusherstvi i hinekolohiy]. Kyyiv, biblioteka "Zdorov'ya Ukrayiny". 2019: 540 [In Ukrainian]. ISBN 978-617-7100- 47-7. This work is licensed under a Creative Commons Attribution 4.0 International License.

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endometriosisadenomyosisdysmenorrheadyspareuniainfertility

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