Neuroendocrine Aspects of Endometriosis‐Associated Pain

Pamela Stratton, Karen J. Berkley
In: Endometriosis · 2011 · pp. 230–239 · doi:10.1002/9781444398519.ch22 · W186741048
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Abstract

Most women experiencing endometriosis-associated pain have chronic pelvic pain. Pain symptoms ascribed to endometriosis and their severity correlate poorly with lesion characteristics and occur in women without endometriosis. Both endometriosis lesions and endometriosis-ascribed pain symptoms are modulated by estrogens and progestogens. Because the nervous system determines the experience of pain and an endometriosis lesion can develop its own nerve supply, the interplay between the nervous and endocrine systems is an important modulator of endometriosis-ascribed pain. Lesions and the nervous system have a direct and two-way interaction that provides a mechanism by which the dynamic and hormonally responsive central and peripheral nervous systems can produce a variety of individual variations in pain that can become independent of endometriosis itself in some women. Improving understanding and alleviating endometriosis-associated pain will likely occur if the emphasis changes from the lesions to pain and studies the interactions between the nervous and endocrine systems in this condition.

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endometriosischronic_pelvic_pain

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