Pain and endometriosis: Etiology, impact, and therapeutics.
Pain and endometriosis: Etiology, impact, and therapeutics.
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DOI：
10.1016/j.mefs.2012.09.002
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发表时间：
2012-12-01
影响因子：
1.3
通讯作者：
Vercellini, Paolo
中科院分区：
文献类型：
--
作者：
Taylor, Robert N;Hummelshoj, Lone;Stratton, Pamela;Vercellini, Paolo
疼痛和子宫内膜异位症的关联是公认的第一个明确发表的报告，这种疾病。不幸的是，导致子宫内膜异位症痛觉和疼痛症状的确切病因和途径仍然知之甚少，因此，缺乏有效的治疗干预措施，从而对受影响妇女的生活质量产生深远影响。在这篇观点论文中，我们总结了在土耳其伊斯坦布尔举行的第28届欧洲人类生殖与胚胎学会（ESHRE）年会上发表的论文，并回顾了慢性疼痛、神经发生和性交困难对症状性子宫内膜异位症妇女的有害影响的临床和转化证据。对药物治疗的有效性进行了严格评估，研究结果表明，现有药物对某些子宫内膜异位症妇女亚组有效，有良好的治疗选择，其中许多药物在全球都负担得起。然而，需要开发新的管理策略和药物来增加所有受影响妇女的选择，以尽量减少和理想地根除子宫内膜异位症的痛苦症状。然而，只有通过阐明具有特定症状的亚组之间的区别，提出不同的机制，我们才有可能得出真正成功的治疗策略。
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.