Endometriosis and pelvic pain: epidemiological evidence of the relationship and implications

A Fauconnier, Arnaud Fauconnier, Fauconnier A, C. Chapron, Chapron C, Charles Chapron
Human Reproduction Update · 2005 · vol. 11(6) , pp. 595–606 · doi:10.1093/humupd/dmi029 · PMID:16172113 · W2124981331
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This review clarifies the links between endometriosis lesion characteristics and chronic pelvic pain, finding endometriosis responsible for pain in over half of confirmed cases and strongly associating severe dysmenorrhea with the condition.

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Abstract

The relationship between chronic pelvic pain symptoms and endometriosis is unclear because painful symptoms are frequent in women without this pathology, and because asymptomatic forms of endometriosis exist. Our comprehensive review attempts to clarify the links between the characteristics of lesions and the semiology of chronic pelvic pain symptoms. Based on randomized trials against placebo, endometriosis appears to be responsible for chronic pelvic pain symptoms in more than half of confirmed cases. A causal association between severe dysmenorrhoea and endometriosis is very probable. This association is independent of the macroscopic type of the lesions or their anatomical locations and may be related to recurrent cyclic micro-bleeding in the implants. Endometriosis-related adhesions may also cause severe dysmenorrhoea. There are histological and physiopathological arguments for the responsibility of deeply infiltrating endometriosis (DIE) in severe chronic pelvic pain symptoms. DIE-related pain may be in relation with compression or infiltration of nerves in the sub-peritoneal pelvic space by the implants. The painful symptoms caused by DIE present particular characteristics, being specific to involvement of precise anatomical locations (severe deep dyspareunia, painful defecation) or organs (functional urinary tract signs, bowel signs). They can thus be described as location indicating pain. A precise semiological analysis of the chronic pelvic pain symptoms characteristics is useful for the diagnosis and therapeutic management of endometriosis in a context of pain.

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Condition tags

dysmenorrheaendometriosischronic_pelvic_paindie_deep_infiltratingdyspareunia

MeSH descriptors

Endometriosis Endometriosis Pelvic Pain Pelvic Pain Bias Chronic Disease Dysmenorrhea Dysmenorrhea Endometriosis Endometriosis Endometriosis Female Humans MEDLINE Pelvic Pain Placebos Randomized Controlled Trials as Topic

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.

References (100)

Cited by (50)

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