Pelvic Pain Symptoms and Inflammation Among Adolescents and Adults with and Without Endometriosis

Authors

Amy Shafrir, Merrimack College, Boston Children's Hospital and Harvard Medical School, Boston Children's Hospital and Brigham and Women's HospitalFollow
Ashley Laliberte, Brigham and Women’s Hospital and Harvard Medical School and Boston Children’s Hospital and Harvard Medical School
Britani Wallace, Brigham and Women's Hospital, Harvard Medical School, and Boston Center for Endometriosis
Allison F. Vitonis, Brigham and Women's Hospital, Harvard Medical School, and Boston Center for Endometriosis
Christine B. Sieberg, Boston Children's Hospital and Harvard Medical School
Marzieh Ghiasi, Cleveland Clinic
Larry I. Magpantay, David Geffen School of Medicine, University of California
Marta Epeldegui, David Geffen School of Medicine, University of California
Andrew Schrepf, Department of Anesthesiology, University of Michigan
Sawsan As-Sanie, Department of Obstetrics and Gynecology, University of Michigan
Kathryn L. Terry, Boston Center for Endometriosis, Boston Children's Hospital and Brigham and Women's Hospital, Harvard Medica School, and Harvard T.H. Chan School of Public Health
Stacey A. Missmer, Boston Center for Endometriosis and Harvard T. H. Chan School of Public Health and Michigan State University

Document Type

Article

Publication Title

International Journal of Molecular Sciences

Publication Date

6-3-2025

Abstract/ Summary

We evaluated inflammatory markers among 389 surgically confirmed endometriosis cases and 505 controls from the Women's Health Study: From Adolescence to Adulthood (A2A) cohort. Participants reported dysmenorrhea, acyclic pelvic pain, dyspareunia, and pain with bowel movements. Using multiplex assays, we measured their levels of plasma interleukin (IL)-1β, -6, -8, -10, and -16, tumor necrosis factor (TNF)-α, monocyte chemotactic protein (MCP)-1 and -4, thymus and activation-regulated chemokine (TARC), and interferon gamma-induced protein (IP)-10. For each symptom, we computed biomarker-level geometric means (GMs) with 95% confidence intervals (95% CI) using multivariate linear regression among the endometriosis cases and controls, with interactions with case/control status tested using Wald statistics. Among the controls, those with dyspareunia had lower levels of IL-8 (GM_present = 4.64 [95% CI = 4.41-4.89] pg/mL vs. GM_absent = 4.99 [95% CI = 4.82-5.17] pg/mL; p = 0.02), and the IL-8 levels were lower for controls reporting pain with bowel movements (GM_present = 4.66 [95% CI = 4.43-4.89] vs. GM_absent = 4.96 [95% CI = 4.82-5.11] pg/mL, p = 0.03). No significant associations between pelvic pain symptoms and inflammatory markers were observed among the endometriosis cases; however, the relationship between inflammatory marker levels and pain experience varied by analgesic use at blood draw. Dyspareunia and pain with bowel movements were associated with inflammatory markers among the controls, while the associations between pelvic pain symptoms and inflammatory markers among the endometriosis cases differed by analgesic use.

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