Risk Factors for Hormonal Therapy Failure in Patients With Endometriosis.

This will be an observational study without the use of medication, multicentric, prospective.

Patients aged between 18 and 50 years, with a clinical and ultrasound diagnosis of endometriosis painful symptoms related to endometriosis (dyspareunia, dyschezia, dysmenorrhea, chronic pelvic pain, dysuria, periovulatory pain, with at least one of these symptoms presenting a Numerical Pain Rating Scale intensity > 5), with an indication for hormonal therapy will be included after the acquisition of informed consent.

On the other hand, patients with contraindications to oral hormonal therapy, those with current or past pelvic infections, with a history of malignancy or current suspicion of malignant gynecological lesions, previous pelvic surgery (hysterectomy, salpingectomy, ovarian cyst removal, myomectomy, surgery for endometriosis, intestinal resections), positive history for other causes of chronic pelvic pain, or women in postmenopausal status will be excluded.

Enrollment will take place among patients who access the specialized endometriosis clinics of the Department of Gynecology and Obstetrics - Prof. Stefano Angioni, and participating centers for an initial visit. During this visit, as per clinical practice, a gynecological examination and a transvaginal gynecological ultrasound will be performed by an expert operator. In the case of an endometriosis diagnosis for which hormonal therapy is indicated and the inclusion and exclusion criteria are met, the patient will be asked to sign the informed consent for participation in the study and consent to the processing of personal data. These patients will be administered scientifically validated questionnaires at the time of the visit (time 0): Endometriosis Health Profile - 30 and the Short Form Health Survey SF - 12 ). The first is a questionnaire widely used in studies analyzing the quality of life of patients with endometriosis as it is specific to the disease, while the second is a generic quality of life questionnaire widely used in literature.

The second evaluation will be conducted 6 months later (time 1) along with a gynecological examination and gynecological ultrasound as per the normal care pathway, and the same questionnaires administered during the enrollment visit will be given again. Patients will be defined as non-responsive to medical therapy if their Endometriosis Health Profile 30 scores are equal to or higher at the "time 1" visit compared to the enrollment visit at "time 0".