Open AccessPain and endometriosis: Etiology, impact, and therapeutics
Author(s) -
Robert N. Taylor,
Lone Hummelshøj,
Pamela Stratton,
Paolo Vercellini
Publication year - 2012
Publication title -
middle east fertility society journal/middle east fertility society journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.322
H-Index - 18
eISSN - 2090-3251
pISSN - 1110-5690
DOI - 10.1016/j.mefs.2012.09.002
Subject(s) - endometriosis , medicine , etiology , extant taxon , pelvic pain , intensive care medicine , psychological intervention , infertility , quality of life (healthcare) , alternative medicine , gynecology , bioinformatics , psychiatry , surgery , pathology , pregnancy , genetics , nursing , evolutionary biology , biology
The association of pain and endometriosis was recognized with the first definitive published reports of this disorder. Unfortunately, the precise etiologies and pathways leading to nociception and pain symptoms in endometriosis remain poorly understood, and as a result, effective therapeutic interventions are lacking with consequent profound effects on affected women's quality of life. In this opinion paper we summarize selected proceedings presented at the 28th Annual Meeting of the European Society of Human Reproduction and Embryology (ESHRE) in Istanbul, Turkey, and review the clinical and translational evidence of chronic pain, neurogenesis, and the pernicious impact of dyspareunia on women with symptomatic endometriosis. The effectiveness of medical treatments is critically assessed and the findings indicate that good therapeutic options are available with extant medications effective in some sub-groups of women with endometriosis, many of which are affordable globally. Nevertheless, new management strategies and drugs need to be developed to increase the options of all afflicted women to minimize and ideally eradicate painful symptoms of endometriosis. However, only by elucidating distinctions among sub-groups with specific symptoms, suggesting different mechanisms, are we likely to derive truly successful therapeutic strategies.