The Relationship between Serum Levels of Oxidative Stress Biomarkers and Dysmenorrhea, Dyspareunia and Pelvic Pain in Women with Endometriosis

Abstract

Background & Aims: Endometriosis is a common disorder associated with an increased risk of cancers, especially ovarian cancer. One of the most prevalent symptoms of this disease is pelvic pain, which is the major complaint among patients during menstruation. While the pathophysiology of endometriosis and the mechanisms responsible for its complications, namely pelvic pain and infertility, are not yet well understood, it seems that oxidative stress plays an undeniable role in the pathogenesis of endometriosis. In other words, the production of large amounts of inflammatory mediators by endometriosis tissue can explain and be responsible for the onset and exacerbation of pelvic pain. There is an apparent imbalance between oxygen free radicals and antioxidants in the endometrial tissue of diagnosed women. In addition, decreased total antioxidant capacity is observed in the peritoneal fluid in women with endometriosis, which is indicative of inadequate antioxidant status. Even though a significant relationship has been reported between symptoms of pelvic pain and indicators of peritoneal oxidative stress in women with endometriosis in some studies, there are still conflicting theories about the relationship between serum biomarkers of oxidative stress and endometriosis. With this background in mind, the present study aimed to determine the relationship between serum levels of oxidative stress biomarkers and dysmenorrhea, dyspareunia, and pelvic pain in women with endometriosis who referred to Sarem Fertility & Infertility Research Center in Tehran, Iran in 2017. Materials & Methods: This was a descriptive, correlational and cross-sectional study performed on 60 women aged 15-49 years with symptoms of endometriosis. The inclusion criteria were diagnosis of endometriosis based on clinical symptoms and laparoscopy, no current pelvic inflammation disease and adenomyosis, no smoking, or alcohol and drug consumption, no chronic underlying diseases, and no psychological diseases (data were obtained through self-report). Subjects were selected by convenience sampling, and written informed consent was obtained from the participants prior to the study. Data were collected using a demographic characteristics questionnaire, fertility profile questionnaire, endometriosis symptoms checklist, research laboratory information record sheet, and visual analogue scale (VAS) for measuring pain. Following filling out the scales and questionnaires, 10 ccs of the blood sample were taken from each of the volunteers under sterile conditions in citrate tubes and stored after centrifugation at -20°C. Afterwards, blood samples were analyzed, and data analysis was carried out in SPSS version 16 using Pearson's correlation coefficient. In addition, a P-value of below 0.05 was considered statistically significant. Results: The mean age of the participants was 33.16 ± 5.41 years and the mean age of their spouses was 35.96 ± 8.62. Moreover, the subjects had a body mass index (BMI) of 25.92 ± 5.94 kg/m2, and most of them were housewives (68.3%) and ha...