Endometriosis and Pain

Guido Orlandini
In: Case Medical Research · 2019 · doi:10.31525/ct1-nct03993197 · W4232473943
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This article discusses how endometriosis-related pain may arise from different pathogenic mechanisms, framing it as a specialized pain (algologic) problem when pain therapy cannot be etiologic. It proposes that some patients experience tissue nociceptive pain due to activation of nociceptors sensitized by endometriosis tissue, which is described as unresponsive to NSAIDs and opioids, while others experience neuropathic pain from nerve damage caused by nerve compression from endometriotic cysts or involvement of nerve structures in scar tissue. The paper also notes that neuropathic pain may respond at least partially to neuropathic-specific pain drugs and electrostimulation, and emphasizes choosing pain therapy based on the underlying mechanism. This paper is centrally about endometriosis — it focuses on mechanisms and treatment logic for endometriosis-associated pain.

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Abstract

In some patients endometriosis causes persistent or chronic pain and is a specialistic algologic problem. Considering various possible pathogenic pain mechanisms, when pain therapy of endometriosis cannot be etiologic, far from be only symptomatic, it is based on a pathogenetic criterion. We must consider that in endometriosis can be a pain due to activation of nociceptors sensibilized by endometriosic tissues (tissutal nociceptive pain) unresponding to NSAIDs and opioids or a pain due to the nerve damage by nerve compression from endometriosic cistis or by involvement of nerve structures in scar tissue (neuropathic pain) unresponding to antinociceptive therapy but responding, at least partially, to some neuropathic specific pain drugs and to electrostimulation of the nerve system.
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Pathos (Mar 2011) Endometriosis and pain Abstract In some patients endometriosis causes persistent or chronic pain and is a specialistic algologic problem. Considering various possible pathogenic pain mechanisms, when pain therapy of endometriosis cannot be etiologic, far from be only symptomatic, it is based on a pathogenetic criterion. We must consider that in endometriosis can be a pain due to activation of nociceptors sensibilized by endometriosic tissues (tissutal nociceptive pain) unresponding to NSAIDs and opioids or a pain due to the nerve damage by nerve compression from endometriosic cistis or by involvement of nerve structures in scar tissue (neuropathic pain) unresponding to antinociceptive therapy but responding, at least partially, to some neuropathic specific pain drugs and to electrostimulation of the nerve system.

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endometriosis

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