To assess prevalence of Central Sensitization (CS) and its association with demographic and clinical factors in patients with endometriosis.

Single center, observational, cross-sectional study.

Consecutive patients with endometriosis referring to center from January 15, 2022 to April 30, 2022.

For each enrolled patient, demographic and clinical data were collected and the presence of CS was measured using the Central Sensitization Inventory (CSI) questionnaire (score ≥40).

Primary study outcome was CS prevalence, while secondary study outcomes were the associations between demographic and clinical factors and CS. The 95% confidence intervals (CI) for CS prevalence were obtained with the Bayesian-derived Jeffreys method, while the associations between CS and demographic and clinical factors were evaluated with the chi-squared test and the Fisher's exact test, where appropriate. The variables significantly associated with CS were then included in a multivariable logistic regression model. The significance level was set at 0.05 for all analyses. During the study period, 285 eligible women were enrolled. CS prevalence was 41.4% (95% CI: 35.8–47.2). At univariable analysis, infertility, moderate-to-severe pain symptoms (except for dyschezia), altered bowel movements, postero-lateral parametrium involvement, hormonal therapy failure (HTF) and most of Central Sensitivity Syndromes (CSSs) were significantly associated to CS occurrence. Multivariable analysis only confirmed the significant association of CS with moderate-to-severe chronic pelvic pain, postero-lateral parametrium involvement, HTF, migraine or tension-type headache, irritable bowel syndrome and anxiety or panic attacks.

CS has a high prevalence in patients with endometriosis, especially in those with moderate-to-severe chronic pelvic pain, postero-lateral parametrium involvement, HTF, and three CSSs (i.e. migraine or tension-type headache, IBS, anxiety or panic attacks). Given the association with HTF, identifying CS through CSI might be useful to counsel the patient and to choose multimodal treatment.