Is There a Role for Acupuncture in Endometriosis Pain, Or ‘endometrialgia’?

Thomas Lundeberg, Iréne Lund
Acupuncture in medicine : journal of the British Medical Acupuncture Society · 2008 · vol. 26(2) , pp. 94–110 · doi:10.1136/aim.26.2.94 · PMID:18591909 · W2154789343
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This paper reviews the mechanisms of endometriosis pain and discusses acupuncture and cognitive therapy as potential adjunct treatments for managing this condition.

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Abstract

Endometriosis is a common cause of pelvic pain in women, many of whom suffer a progression of symptoms over their menstrual life. Symptoms may include combinations of abnormal visceral sensations and emotional distress. Endometriosis pain, or 'endometrialgia' often has a negative influence on the ability to work, on family relationships and sense of worth. Endometrialgia is often considered to be a homogeneous sensory entity, mediated by a specialised high threshold sensory system, which extends from the periphery through the spinal cord, brain stem and thalamus to the cerebral cortex. However, multiple mechanisms have been detected in the nervous system responsible for the pain including peripheral sensitisation, phenotypic switches, central sensitisation, ectopic excitability, structural reorganisation, decreased inhibition and increased facilitation, all of which may contribute to the pain. Although the causes of endometrialgia can differ (eg inflammatory, neuropathic and functional), they share some characteristics. Endometrialgia may be evoked by a low intensity, normally innocuous stimulus (allodynia), or it may be an exaggerated and prolonged response to a noxious stimulus (hyperalgesia). The pain may also be spontaneous in the absence of any apparent peripheral stimulus. Oestrogens and prostaglandins probably play key modulatory roles in endometriosis and endometrialgia. Consequently many of the current medical treatments for the condition include oral drugs, like non-steroid anti-inflammatory drugs, contraceptives, progestogens, androgenic agents, gonadotrophin releasing hormone analogues, as well as laparoscopic surgical excision of the endometriosis lesions. However, management of pain in women with endometriosis is currently inadequate for many. Possibly acupuncture and cognitive therapy may be used as an adjunct.

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Acupuncture Endometriosis Pain Management Endometriosis Female Ganglia, Spinal Ganglia, Spinal Humans Nociceptors Nociceptors Pain Pain Spinal Cord Spinal Cord

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 (17)

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License: CC0 · commercial use OK