Pathophysiology of endometriosis-associated pain: A review of pelvic and central nervous system mechanisms

Lydia Coxon, Andrew W Horne, Katy Vincent
Best practice & research. Clinical obstetrics & gynaecology · 2018 · vol. 51 , pp. 53–67 · doi:10.1016/j.bpobgyn.2018.01.014 · PMID:29525437 · W2792525997
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-13 ⓘ

This review examines pelvic and central nervous system mechanisms, including nerve growth, inflammation, and stress, involved in the poorly understood pathophysiology of endometriosis-associated pain.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This paper is a narrative review examining the neurobiology of pain and the specific pelvic and central nervous system mechanisms thought to contribute to endometriosis-associated pain. It discusses pelvic factors such as new nerve fibre growth, peritoneal fluid, and inflammation, emphasizing studies that link these factors to pain symptoms rather than only comparing endometriosis and control groups, and then reviews central modulation via the stress axis and psychological factors. A key limitation stated is that the biological mechanisms underlying pain are still poorly understood and that symptom severity has poor correlation with disease burden, constraining mechanistic interpretation. This paper is centrally about endometriosis — it reviews pelvic and central nervous system mechanisms implicated in endometriosis-associated pain.

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Journal article Pathophysiology of endometriosis-associated pain: a review of pelvic and central nervous system mechanisms - Abstract: - Although pain is one of the main symptoms women with endometriosis present with, there is poor correlation between symptom severity and disease burden and the underlying biological mechanisms by which pain arises are still only poorly understood. We briefly review the neurobiology of pain before considering mechanisms that may be specifically relevant in the context of endometriosis. The role of pelvic factors such as new nerve fibre growth, peritoneal fluid and inflammation is explored with a particular focus on studies where these factors have been associated with pain symptoms rather than just being compared between women with endometriosis and disease-free controls. We then consider the role of the central nervous system and associated systems, including the stress axis and psychological factors, in the modulation of pain. The potential for changes in these systems to be a cause and/or a consequence of the pain and how they might explain some of the known associations between endometriosis and other somatic symptoms is discussed. The chapter concludes by considering the implications of these mechanisms on treatment strategies for these women. - Publication status: - Published - Peer review status: - Peer reviewed Actions Access Document - Files: - - (Preview, Accepted manuscript, pdf, 1.0MB, Terms of use) - - Publisher copy: - 10.1016/j.bpobgyn.2018.01.014 Authors - Publisher: - Elsevier - Journal: - Best Practice and Research: Clinical Obstetrics and Gynaecology More from this journal - Volume: - 51 - Pages: - 53-67 - Publication date: - 2018-02-15 - Acceptance date: - 2018-01-23 - DOI: - EISSN: - 1532-1932 - ISSN: - 1521-6934 - Keywords: - Pubs id: - pubs:829508 - UUID: - uuid:bfb1d739-f57e-4194-b6af-b44d92e05e0c - Local pid: - pubs:829508 - Source identifiers: - 829508 - Deposit date: - 2018-03-14 - ARK identifier: Terms of use - Copyright holder: - Elsevier Ltd - Copyright date: - 2018 - Notes: - Copyright © 2018 Published by Elsevier Ltd. This is the accepted manuscript version of the article. The final version is available online from Elsevier at: https://doi.org/10.1016/j.bpobgyn.2018.01.014 If you are the owner of this record, you can report an update to it here: Report update to this record

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Condition tags

dysmenorrheaendometriosis

MeSH descriptors

Autonomic Nervous System Chronic Pain Chronic Pain Chronic Pain Chronic Pain Endometriosis Endometriosis Endometriosis Endometriosis Autonomic Nervous System Case-Control Studies Dysmenorrhea Dysmenorrhea Dysmenorrhea Female Humans Ovary Ovary Pain Measurement Pain Measurement

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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