Pathophysiology of Endometriosis-Associated Pelvic Pain pp. 131-150
Authors: (Julia Arnold, Sylvia Mechsner, Endometriosis Research Centre Charité, Department of Gynaecology, Charité, Campus Benjamin Franklin, Hindenburgdamm, Berlin, Germany)
Abstract: Endometriosis is an estrogen-dependent disease, characterised by the presence of endometrial glands, stromal and smooth muscle cells outside the uterine cavity, affecting 10-15% of women in reproductive age. The gold standart to diagnose endometriosis is visualization at surgery.The average diagnostic effort takes up to 8 years. 50 to 60% of women and teenage girls with pelvic pain suffer from endometriosis while other symptoms like severe dysmenorrhea, chronic pelvic pain, dyspareunia, dyschezia and dysuria often occure coevally. Endometriosis causes disability and compromised quality of life in women and young girls. Pain generation in endometriosis is an intricate interplay of several factors such as the endometriotic lesions itself and the pain mediating substances produced there, nerve fibers and cytokine releasing immune cells and macrophages. These interactions seem to induce a neurogenic inflammatory process.