A deep insight into pelvic pain and endometriosis: a review of the literature from pathophysiology to clinical expressions

Masciullo, Luisa; Viscardi, Maria Federica; Piacenti, Ilaria; Scaramuzzino, Sara; Cavalli, Alessandra; Piccioni, Maria Grazia; Porpora, Maria Grazia

doi:10.23736/s2724-606x.21.04779-1

Cited by 15 publications

(9 citation statements)

References 100 publications

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“…These stages are differentiated by the advancement of changes in the depth and location of implants as well as the presence and location of adhesions. However, scientific evidence suggests that a correlation between the severity of pain and the stage of endometriosis is rare [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Low Diet Quality and Nutritional Knowledge in Women with Endometriosis: A Pilot Study

Bogusz,

Górnicka

2024

Healthcare

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Endometriosis is a chronic gynecological disease characterized by ectopic endometrial tissue outside the uterus that can cause chronic pain, dysmenorrhea, fatigue, and infertility. The aim of this study was to assess diet quality and nutritional knowledge of women with endometriosis. A questionnaire was used to collect data on lifestyle, dietary habits and nutritional knowledge from 90 women. More than 80% of women with endometriosis (82.2%) confirmed that diet and lifestyle are related to the progression of endometriosis. After being diagnosed with endometriosis, 77.3% of respondents reported a change in their dietary habits and made various changes to their diet by increasing or eliminating the consumption of certain foods. The majority declared reducing pro-inflammatory products, increasing anti-inflammatory foods, including the consumption of vegetables and fruits, avoiding white/or red/or processed meat, and avoiding sweets. Nevertheless, diet quality as assessed by the pro-healthy diet index (pHDI-10) and the Mediterranean Diet Score (MDS) showed a low intensity of consumption of pro-healthy food (average pHDI-10 value 31.4%; MDS 7.55/14 points, p = 0.0001). Women with endometriosis reported lower than recommended consumption of fruits, vegetables, dairy products and whole grains. A higher percentage of healthy controls had a “good” level of nutritional knowledge than women with endometriosis. The results of our study highlight the need to improve diet quality and nutritional knowledge among women with endometriosis as well as developing targeted dietary recommendations to help improve well-being and reduce the pain symptoms of endometriosis.

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Section: Introductionmentioning

confidence: 99%

Low Diet Quality and Nutritional Knowledge in Women with Endometriosis: A Pilot Study

Bogusz,

Górnicka

2024

Healthcare

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“…These inflammatory processes might be the driver of the observed anxiety-related behavior, given that the pro-inflammatory cytokine IL-1β has demonstrated anxiogenic effects in mice ( Munshi et al, 2019 ), and inflammatory processes including upregulation of IL-1b was described in peritoneal fluid of endometriosis patients ( Mori et al, 1991 ). Another possibility is that endometriosis-pain chronically activate the hypothalamus-pituitary-adrenal (HPA) axis, leading to permanently increased cortisol levels and anxiety, as observed in endometriosis patients ( Masciullo et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Anxiety-related behaviors without observation of generalized pain in a mouse model of endometriosis

Nunez-Badinez

Laux-Biehlmann²,

Hayward³

et al. 2023

Front. Behav. Neurosci.

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Endometriosis is a chronic, hormone-dependent, inflammatory disease, characterized by the presence and growth of endometrial tissue outside the uterine cavity. It is associated with moderate to severe pelvic and abdominal pain symptoms, subfertility and a marked reduction in health-related quality of life. Furthermore, relevant co-morbidities with affective disorders like depression or anxiety have been described. These conditions have a worsening effect on pain perception in patients and might explain the negative impact on quality of life observed in those suffering from endometriosis-associated pain. Whereas several studies using rodent models of endometriosis focused on biological and histopathological similarities with the human situation, the behavioral characterization of these models was never performed. This study investigated the anxiety-related behaviors in a syngeneic model of endometriosis. Using elevated plus maze and the novel environment induced feeding suppression assays we observed the presence of anxiety-related behaviors in endometriosis-induced mice. In contrast, locomotion or generalized pain did not differ between groups. These results indicate that the presence of endometriosis lesions in the abdominal cavity could, similarly to patients, induce profound psychopathological changes/impairments in mice. These readouts might provide additional tools for preclinical identification of mechanisms relevant for development of endometriosis-related symptoms.

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“…Endometriosis is a chronic, estrogen-dependent, benign, inflammatory disease, affecting between 2–10% of women in childbearing age, characterized by the presence of endometrial glands and stroma outside the uterine cavity [ 1 ]. The pivotal symptom of endometriosis is pain, presenting as dysmenorrhea, dyspareunia, or chronic pelvic pain (CPP), and it is associated with infertility in up to 50% of cases [ 2 , 3 ]. Environmental, dietary, genetic, and immune factors seem to be involved in the etiopathogenesis of endometriosis [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of N-Acetylcysteine on Endometriosis-Related Pain, Size Reduction of Ovarian Endometriomas, and Fertility Outcomes

Anastasi

Scaramuzzino

Viscardi

et al. 2023

IJERPH

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Background: Endometriosis is a chronic, estrogen-dependent, inflammatory disease, whose pivotal symptoms are dysmenorrhea, dyspareunia, and chronic pelvic pain (CPP). Besides the usual medical treatments, recent evidence suggests there are potential benefits of oral N-acetylcysteine (NAC) on endometriotic lesions and pain. The primary objective of this prospective single-cohort study was to confirm the effectiveness of NAC in reducing endometriosis-related pain and the size of ovarian endometriomas. The secondary objective was to assess if NAC may play a role in improving fertility and reducing the Ca125 serum levels. Methods: Patients aged between 18–45 years old with a clinical/histological diagnosis of endometriosis and no current hormonal treatment or pregnancy were included in the study. All patients received quarterly oral NAC 600 mg, 3 tablets/day for 3 consecutive days of the week for 3 months. At baseline and after 3 months, dysmenorrhea, dyspareunia and CPP were assessed using the Visual Analog Scale score (VAS), while the size of the endometriomas was estimated through a transvaginal ultrasound. Analgesics (NSAIDs) intake, the serum levels of Ca125 and the desire for pregnancy were also investigated. Finally, the pregnancy rate of patients with reproductive desire was evaluated. Results: One hundred and twenty patients were recruited. The intensity of dysmenorrhea, dyspareunia and CPP significantly improved (p < 0.0001). The use of NSAIDs (p = 0.001), the size of the endometriomas (p < 0.0001) and the serum levels of Ca125 (p < 0.0001) significantly decreased. Among the 52 patients with reproductive desire, 39 successfully achieved pregnancy within 6 months of starting therapy (p = 0.001). Conclusions: Oral NAC improves endometriosis-related pain and the size of endometriomas. Furthermore, it decreases Ca125 serum levels and may improve fertility in patients with endometriosis.

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A deep insight into pelvic pain and endometriosis: a review of the literature from pathophysiology to clinical expressions

Cited by 15 publications

References 100 publications

Low Diet Quality and Nutritional Knowledge in Women with Endometriosis: A Pilot Study

Low Diet Quality and Nutritional Knowledge in Women with Endometriosis: A Pilot Study

Anxiety-related behaviors without observation of generalized pain in a mouse model of endometriosis

Efficacy of N-Acetylcysteine on Endometriosis-Related Pain, Size Reduction of Ovarian Endometriomas, and Fertility Outcomes

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