Importance of an Interdisciplinary Approach in the Treatment of Women with Endometriosis and Chronic Pelvic Pain - Revista Brasileira de Ginecologia e Obstetrícia
Rev Bras Ginecol Obstet. 2023;45(11):635-637
Endometriosis, from a pathophysiological standpoint, can be defined as active endometrium-like tissue outside the uterus. However, to better understand and approach this complex disease, it should be addressed as a chronic inflammatory disease that can cause pelvic pain during a long period of a women’s reproductive lifetime. Due to nociplasty, women affected by endometriosis can also maintain pain despite adequate organic treatment, especially considering that this disease has no objective cure., On the other hand, chronic pelvic pain(CPP) can be defined as pain perceived in the lower abdomen, lasting for at least six months, that has a negative impact on quality of life and that demands treatment. CPP may have a gynecologic etiology such as endometriosis, but most frequently has a multifactorial nature, involving gastrointestinal, urinary, psychological, and musculoskeletal systems.
Furthermore, women suffering from endometriosis frequently manifest other overlapping pain conditions such as irritable bowel syndrome, painful bladder syndrome, fibromyalgia, migraine headaches, among others. This may be due to a lower pain threshold, cross-organ sensitization, enhanced visceral pain or a common pathophysiological origin yet to be elucidated. Therefore, when managing pain in women suffering from endometriosis and/or CPP, an isolated gynecological approach will usually be insufficient.
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Endometriosis, from a pathophysiological standpoint, can be defined as active endometrium-like tissue outside the uterus. However, to better understand and approach this complex disease, it should be addressed as a chronic inflammatory disease that can cause pelvic pain during a long period of a women's reproductive lifetime. Due to nociplasty, women affected by endometriosis can also maintain pain despite adequate organic treatment, especially considering that this disease has no objective cure., On the other hand, chronic pelvic pain(CPP) can be defined as pain perceived in the lower abdomen, lasting for at least six months, that has a negative impact on quality of life and that demands treatment. CPP may have a gynecologic etiology such as endometriosis, but most frequently has a multifactorial nature, involving gastrointestinal, urinary, psychological, and musculoskeletal systems.
Furthermore, women suffering from endometriosis frequently manifest other overlapping pain conditions such as irritable bowel syndrome, painful bladder syndrome, fibromyalgia, migraine headaches, among others. This may be due to a lower pain threshold, cross-organ sensitization, enhanced visceral pain or a common pathophysiological origin yet to be elucidated. Therefore, when managing pain in women suffering from endometriosis and/or CPP, an isolated gynecological approach will usually be insufficient.
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