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

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 fluid, is not observed in the blood. The results were indicative of no significant relationship between chronic leg pain and dyspareunia with levels of oxidative stress biomarkers. It is generally believed that an increase in oxidative stress of those with dysmenorrhea depends on oxygen-free radicals. However, no studies have clearly mentioned the existence and relationship of oxygen-free radical balance and antioxidant systems with dysmenorrhea. Nonetheless, further studies are required to investigate this issue. It is recommended that oxidative stress biomarkers in peritoneal fluid in women with endometriosis be evaluated in future studies.