Endometriosis in Reproductive Years: The Origin of Pain in Endometriosis and Adenomyosis

Endometriosis is a chronic inflammatory disease that affects women during their reproductive years. Endometriotic lesions can be disseminated in the myometrium (adenomyosis uteri) or are generally localized in the pelvis and are rarely found in the upper abdomen (endometriosis genitalis externa or extragenitalis). These lesions lead to chronic inflammation. The intense pain caused by endometriosis is manifold. In addition to nociceptive pain, there is also a nociplastic reaction with central sensitization. Atypical symptoms such as acyclic lower abdominal pain, radiating pain, non-specific bladder and intestinal complaints or even depressions are frequent as are classic cyclical complaints such as severe dysmenorrhea, cyclical lower abdominal pain, dyspareunia, dysuria and dyschezia. In cases of a diffuse range of symptoms, patients often consult not just gynaecologists but also specialists from other disciplines (internal medicine, gastroenterology, orthopaedics, pain therapy, psychology, etc.). The origin of pain is complex. Both peripheral and central sensitization of pain mechanisms but also hormonal, psychological and muscular changes play a major role in the pain process. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

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