Introduction: Endometriosis is a common pathology affecting one in 10 women, characterized by the ectopic development of endometrium, which can cause pain and/or infertility. This pathology is primarily determined by hereditary factors, but it is also susceptible to environmental influences, such as the age of the onset of menstruation or exposure to chemical substances that modify the endocrine system. Recent studies have highlighted that endometriosis is more common in women with relatively short ano-genital distances (AGD), and that sensitivity to pain is closely linked to adult levels of testosterone (T) or oxytocin (OT). Aim: The main objective is to compare the anogenital distance (AGD) between two groups of women: one with stage III or IV endometriosis (ENDO +) and another group without endometriosis confirmed by laparoscopy (ENDO -). The secondary objectives are to compare various factors between the 2 groups : * Basal testosterone levels in blood. * Variations in blood testosterone levels before and after a video stimulating empathy. * Basal oxytocin levels in saliva. * Variations in oxytocin levels in saliva before and after an empathy-stimulating video. * Pelvic pain, between D2 and D5 after the start of the menstrual cycle. For the ENDO + group only: * Evaluate patients' quality of life, between D2 and D5 after the start of the menstrual cycle. * Correlate pain experienced over the last 4 weeks with hormonal markers (AGD, T, OT). Methods: Participants in the ENDO+ group will fill in a questionnaire assessing the impact of pain experienced over the past 4 weeks on their quality of life. D0 is defined as the day when participants experience a menstrual bleed before 10 am. All participants will return for project-specific hospital appointment between D2 and D5 after the start of their menstrual cycle to measure T, Sex Hormone-Binding Globulin (SHBG) and OT. During this consultation, the following samples will be taken: * 10mL blood sample * 2mL saliva sample Both samples will be taken at t0 (before watching the video) and t1 (20 minutes after watching the video).
Study Type
OBSERVATIONAL
Enrollment
40
Several measurements of the testosterone concentration will be performed on serum from 10 mL of blood collected at: * t0 corresponding to the start of the hospital appointment and before watching the video * t1 which corresponds to 20 minutes after watching a 2 minutes empathy-inducing video
Several measurements of the oxytocin concentration will be performed on 2 ml saliva samples: * t0 corresponding to 20 minutes after the start of the hospital appointment and before watching the video * t1 which corresponds to 20 minutes after watching a 2 minutes empathy-inducing video
CHU de Montpellier
Montpellier, France
RECRUITINGMeasure of the anogenital distance (AGD)
AGD is measured at enrollment for patients already diagnosed by Magnetic resonance imaging (MRI), and it is measured during the laparoscopy once the diagnosis has been confirmed. AGD is measured by 2 different operators with a millimetric precision ruler according 2 validated methods : * measure of the distance from the clitoral surface to the anus (AGD-AC), and * measure of the distance from the posterior fourchette to the anus (AGD-AF). The method is described here: https://www.jove.com/v/57912/ Each operator will measure the AGD-AC and the AGD-AF 3 times. For each type of AGD, the final value will correspond to the mean of the 6 values.
Time frame: At diagnosis or at inclusion
Basal total testosterone
The basal total testosterone (Ttotal(t0)) level is measured in blood
Time frame: t0 : Between the second and the fifth day of the menstrual cycle, before wathching an empathy-inducing video
Basal bio-available testosterone
The basal bio-available testosterone (Tbio-available(t0)) level is measured in blood
Time frame: t0 : Between the second and the fifth day of the menstrual cycle, before wathching an empathy-inducing video
Basal sex hormone-binding globulin
Basal sex hormone-binding globulin (SHBG(t0)) level is mesured in blood
Time frame: t0 : Between the second and the fifth day of the menstrual cycle, before watching an empathy-inducing video
Basal Free Androgen Index
Basal Free Androgen Index (FAI(t0)) = (Ttotal(t0)/SHBG(t0))\*100
Time frame: t0 : Between the second and the fifth day of the menstrual cycle, before watching an empathy-inducing video
Total testosterone after empathy induction
The total testosterone level after empathy induction (Ttotal(t1)) is measured in blood
Time frame: t1 : Between the second and the fifth day of the menstrual cycle, after wathching an empathy-inducing video
Bio-available testosterone after empathy induction
The bio-available testosterone level after empathy induction (Tbio-available(t1)) is measured in blood
Time frame: t1 : Between the second and the fifth day of the menstrual cycle, after wathching an empathy-inducing video
Sex hormone-binding globulin after empathy induction
Sex hormone-binding globulin after empathy induction (SHBG(t1)) is mesured in blood
Time frame: t1 : Between the second and the fifth day of the menstrual cycle, after wathching an empathy-inducing video
Free Androgen Index after empathy induction
Free Androgen Index after empathy induction (FAI(t1)) = (Ttotal(t1)/SHBG(t1))\*100
Time frame: t1 : Between the second and the fifth day of the menstrual cycle, after wathching an empathy-inducing video
Variation in total testosterone levels before and after an empathy-inducing video
The level of variation in total testosterone before (t0) and after watching empathy-inducing video (t1) is assessed according to: Ttotal(t1)-Ttotal(t0)
Time frame: t1 : Between the second and the fifth day of the menstrual cycle, after wathching an empathy-inducing video
Variation in bio-available testosterone levels before and after an empathy-inducing video
The level of variation in bio-available testosterone before (t0) and after watching empathy-inducing video (t1) is assessed according to: Tbio-available(t1)-Tbio-available(t0)
Time frame: t1 : Between the second and the fifth day of the menstrual cycle, after wathching an empathy-inducing video
Variation in Sex hormone-binding globulin levels before and after an empathy-inducing video
The level of variation in Sex hormone-binding globulin before (t0) and after watching empathy-inducing video (t1) is assessed according to: SHBG(t1)-SHBG(t0)
Time frame: t1 : Between the second and the fifth day of the menstrual cycle, after wathching an empathy-inducing video
% of variation in Free Androgen Index before and after an empathy-inducing video
% of variation in Free Androgen Index before (t0) and after watching empathy-inducing video (t1) is assessed according to: \[\[FAI(t1)-FAI(t0)\]/FAI(t0)\] × 100
Time frame: t1 : Between the second and the fifth day of the menstrual cycle, after wathching an empathy-inducing video
Basal oxytocin (OT) level
The basal OT level is measured by the dosage in the saliva of : Total OT (OTtotal(t0))
Time frame: t0 : Between the second and the fifth day of the menstrual cycle, before wathching an empathy-inducing video
Oxytocin (OT) level after empathy induction
The basal OT level is measured by the dosage in the saliva of : Total OT (OTtotal(t1))
Time frame: t1 : Between the second and the fifth day of the menstrual cycle, after wathching an empathy-inducing video
Variation in oxytocin (OT) level before and after an empathy-inducing video
Variation in OT level before (t0) and after watching an empathy-inducing video (t1) is assessed in the saliva according to: \- OTtotal(t1)-OTtotal(t0) -% of variation of OT = \[\[OT(t1)-OT(t0)\]/OT(t0)\] × 100
Time frame: t1 : Between the second and the fifth day of the menstrual cycle, after wathching empathy-inducing video
Area under the Receiving Operator Characteristic (ROC) curve for AGD
The ROC curve is a graphical representation that illustrates the performance of a binary classification model. It plots the true positive rate (sensitivity) against the false positive rate (1 - specificity) at various classification thresholds. In other words, the model's sensitivity corresponds to the model's ability to detect patients (ENDO+) while the model's specificity corresponds to the model's ability to detect a non-patient (ENDO-). The ROC curve helps assess the model's ability to correctly identify true positives while minimizing false positives. The area under the ROC curve (AUC) can be interpreted as the probability that, among two randomly chosen subjects, a patient and a non-patient, the value of the marker is higher for the patient than for the non-sick. An AUC of 0.5 (50%) indicates that the marker is non-informative. An increase in AUC indicates an improvement in discriminatory abilities, with a maximum of 1.0 (100%).
Time frame: At diagnosis (ENDO+) or at enrollment (ENDO-)
Pelvic pain intensity
Pelvic pain will be assessed using a Visual Analogue Scale (VAS). The visual analog scale (VAS) is a validated, unidimensional subjective measure for acute and chronic pain. Scores are recorded by making a handwritten mark on a 10-cm line that represents a continuum between "no pain" and "worst pain."
Time frame: t0 : Between the second and the fifth day of the menstrual cycle, before watching an empathy-inducing video
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