Pain Management for Women with Endometriosis

Daniela Rangel-Santos, Gabriela Cavalcanti Freitas Félix Rangel, German William Rangel, Sudhir Diwan
In: Obstetrics and Gynecology · 2024 · doi:10.5772/intechopen.1007679 · W4404243856
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⚙ AI-generated summary by claude@2026-06, 2026-06-06 ⓘ

This review explores pharmacological, interventional, physical, and behavioral therapies for managing chronic pelvic pain in women with endometriosis, highlighting neuromodulation as a promising option for refractory cases.

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Abstract

Endometriosis is a leading cause of chronic pelvic pain in women and requires multidimensional lifelong management strategies. This chapter comprehensively reviews the multidisciplinary approaches to pain management in women with endometriosis, emphasizing both pharmacological and interventional strategies. Medical management includes non-steroidal anti-inflammatory drugs (NSAIDs) and hormonal contraceptives as the first line of treatment, providing adequate pain relief for many patients. Other pharmacological options include tricyclic and serotonin and norepinephrine reuptake inhibitors (SNRI) antidepressants, calcium channel blockers, GnRH agonists/antagonists, and aromatase inhibitors. Some disadvantages related to pharmacological treatment include inhibition of ovulation, side effects of medications, and high recurrence of pain after discontinuation of treatment. Surgical management is usually delayed due to the risk of pelvic organ damage and postoperative adhesion formation. Physical and behavioral therapy are encouraged as a comprehensive approach to chronic pelvic pain. Interventional pain management techniques have emerged as a therapeutic option providing adequate pain control without impairing fertility. Neuromodulatory techniques such as peripheral nerve stimulation, dorsal root ganglion, and spinal cord stimulation could be a promising line of treatment for patients with refractory pain.

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Condition tags

endometriosischronic_pelvic_pain

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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