How to Understand the Complexity of Endometriosis-Related Pain

Abstract

women of reproductive age are affected by endometriosis. Severe symptoms characterized by endometriosis include: dysmenorrhea, dyspareunia, dyschezia, dysuria, cyclic and acyclic pelvic pain, menstrual disorders and infertility. These symptoms have extreme human, clinical and economic relevance (1, 2). Although they are relatively specific for endometriosis, there is normally a long delay between the onset of symptoms and establishing an official diagnosis. Frequently, the final diagnosis occurs after 10 visits to different physicians (3). The current average time of diagnosis is between 6-8 years. The wide range of many other nonspecific symptoms such as bowel and bladder complaints, emission of pain in the legs, vegetative concomitants like vomiting, emesis, gastric disorders, headaches, dizziness, painful ovulation, irregular pelvic pain, lower back pain, chronic fatigue (Tab. I) could be the reason for that. This leads to a misunderstanding of the situation and often to the incorrect diagnosis. Gynecologists should have a

Learning endometriosis phenotypes from patient-generated data

“…The observed commonality of pelvic and lower back pain symptoms across phenotypes is expected for endometriosis patients 44 , as well as having gastrointestinal symptoms related to irritable-bowel syndrome 45,46 . Our analysis shows spotting and bleeding outside of the period to be characteristic of all participants in our cohort, which matches findings connecting premenstrual spotting with histologically confirmed endometriosis 47 .…”

Endometriosis Associated Infertility: A Critical Review and Analysis on Etiopathogenesis and Therapeutic Approaches

“…Pelvic pain is characterized by a dull, sharp, throbbing, or burning sensation, while dysmenorrhea is described as pelvic pain that presents before, during, and/or after menstruation. Compression and infiltration of the nerves in the endometrial lesions represent the main cause of pain development in endometriosis, although other mechanisms such as the nociceptive pain component of neuropathic pain, neurogenic inflammatory processes, and myogenic pain along with alterations in peripheral and central nervous system pain processing have been considered in generating the endometriosis-associated pelvic pain complex pathology [ 31 , 32 ]. One research team from Brazil proposed a theory of perineural spread in 2015, in which they concluded that several interactions occur at the subcellular level between endometriosis lesions and somatic peripheral nerves [ 33 ].…”

MRT der Endometriose und Adenomyose

“…Als Adenomyose (Endometriosis genitalis interna) wird das Vorkommen von endometriumähnlichem Epithel und Stroma innerhalb des Myometriums bezeichnet. Ferner wird auch das Vorkommen von endometriumähnlichem Epithel und Stroma in den Tuben als Endometriosis genitalis interna bezeichnet [3]. Zu beachten ist, dass auch bei asymptomatischen Frauen Endometrioseläsionen vorkommen können, z.…”