MECHANISMS OF PAIN IN WOMEN WITH ENDOMETRIOSIS

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Endometriosis is a common ailment estimated to affect 12% of reproductive-aged women and up to 80% of women with chronic pelvic pain. Standard medical and surgical treatments used to treat women with endometriosis are insufficient because many women do not get adequate relief of their pain and pain often returns even if they initially responded to treatment. Despite the high frequency and often negative impact on women's lives, little is known about why and how some, but not all, women with endometriosis develop chronic pelvic pain. A variety of possibilities have been explored with numerous studies failing to find an association between pain symptoms and the extent or spread of the endometriosis implants. Pain in other chronic pain syndromes, such as irritable bowel syndrome, fibromyalgia, temporomandibular disorders, and vulvodynia, has been shown to be related to abnormalities in the way the brain processes and interprets pain, rather than from direct damage or inflammation of specific organs or tissues. A common finding in these pain syndromes is increased tenderness to pressure, even far away from the primary site of pain symptoms. Successful treatment of these chronic pain disorders often includes medications that improve the way the brain processes and interprets pain. Preliminary research in a small number of women with endometriosis and chronic pelvic pain suggests that abnormalities in pain processing may also be a problem in this condition. If such abnormalities are confirmed in women with endometriosis-associated chronic pelvic pain, this could result in a paradigm shift in the treatment of this condition. In addition to therapies aimed at suppressing or excising endometriosis implants (i.e. hormonal medications and/or surgery), some women may also benefit from treatments aimed at correcting abnormalities in pain processing. Thus, the overall purpose of this research study is to better understand the cause of chronic pelvic pain in women with endometriosis. The specific aims of this study are to describe the spectrum of physical, biochemical, and psychological function of women with endometriosis and determine whether an abnormality in pain processing occurs in a subset of women with endometriosis-associated chronic pelvic pain. The study involves a medical interview and examination, filling out several questionnaires, a blood draw, and a brief pain testing session.'