Hypothalamic-Pituitary-Adrenal Axis Responses in Women with Endometriosis-Related Chronic Pelvic Pain

Robin Ortiz, Julie Anne L Gemmill, Ninet Sinaii, Barbara J. Stegmann, Barbara Stegmann, I. Khachikyan, Izabella Khachikyan, George Chrousos, George P. Chrousos, James Segars, James H. Segars, Pamela Stratton
Reproductive sciences (Thousand Oaks, Calif.) · 2020 · vol. 27(10) , pp. 1839–1847 · doi:10.1007/s43032-020-00201-x · PMID:32572832 · W3036818278
article OA: green CC0 ⤵ 6 in-corpus citations
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-10 ⓘ

HPA axis responses to CRH administration did not differ between women with endometriosis-related chronic pelvic pain and healthy volunteers, but were higher in Black women and blunted in white women with more severe pain.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

This cross-sectional study measured hypothalamic-pituitary-adrenal axis responses to intravenous ovine corticotropin-releasing hormone in 54 racially diverse women with endometriosis-associated chronic pelvic pain (n=22), chronic pelvic pain without endometriosis (n=12), or healthy volunteers (n=20), assessing ACTH and cortisol at baseline and multiple post-injection times. Overall, HPA axis responses (ACTH/cortisol delta and area under the curve) did not differ by pain status or between groups, and the authors report that race did not change results unless analyses were stratified. When stratified by race, black women showed higher ACTH and cortisol responses than predominately white (non-black) women, and within primarily white women, greater menstrual or non-menstrual pain severity was associated with blunted ACTH or cortisol responses. This paper does not explicitly address the limitation of small subgroup sizes in the excerpt provided; relevance to endometriosis: the study includes women with endometriosis-associated chronic pelvic pain alongside pelvic pain without endometriosis and interprets that pain-associated HPA differences may occur independently of endometriosis lesions, even though the HPA response did not differ overall between pain groups. This paper is centrally about endometriosis — it experimentally tests HPA axis reactivity in women with endometriosis-related chronic pelvic pain.

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Condition tags

mesh:D004715mesh:D017699endometriosischronic_pelvic_pain

MeSH descriptors

Adrenocorticotropic Hormone Chronic Pain Endometriosis Hydrocortisone Hypothalamo-Hypophyseal System Pelvic Pain Pituitary-Adrenal System Adrenocorticotropic Hormone Adult Chronic Pain Chronic Pain Chronic Pain Corticotropin-Releasing Hormone Corticotropin-Releasing Hormone Cross-Sectional Studies Endometriosis Endometriosis Endometriosis Female Humans

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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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