Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2008 Oct;12(5):382-95.
doi: 10.1111/j.1751-486X.2008.00362.x.

Endometriosis and Chronic Pelvic Pain: Unraveling the Mystery Behind this Complex Condition

Terri Bloski  1 , Roger Pierson
Affiliations
Review

Endometriosis and Chronic Pelvic Pain: Unraveling the Mystery Behind this Complex Condition

Terri Bloski et al. Nurs Womens Health. 2008 Oct.

Abstract

Nurses often encounter patients with chronic pelvic pain associated with endometriosis, which is a puzzling and problematic gynecologic condition that has continued to plague women and baffle doctors and researchers worldwide since it was first identified by Dr. J. Sampson in the 1920s (Sampson, 1940). Endometriosis is defined as the growth, adhesion and progression of endometrial glands and stroma outside of the uterine cavity, with cellular activity evident in lesions, nodules, cysts or endometriomas (Audebert et al., 1992). Although it typically appears benign on histopathology, endometriosis has been likened to a malignant tumor since the lesions grow, infiltrate and adhere to adjacent tissues and interfere with physiologic processes (Kitawaki et al., 2002; Noble, Simpson, Johns, & Bulun, 1996). Ectopic endometriotic growths respond to cyclic changes of estrogen and proliferate and shed in a manner similar to eutopic endometrium. This cyclic ectopic activity results in internal bleeding, formation of scar tissue, inflammation and sometimes debilitating chronic pain (Kitawaki et al.).

PubMed Disclaimer

Figures

Figure 1
Figure 1. Laparoscopic visualization of endometrial lesions (A – F)
(A)Isolated red lesions located on broad ligament. (B)Multiple red lesions adjacent to sigmoid colon. Laparoscopic instrument visualized in the top center portion of image. Lesions visualized directly to left of instrument. (C)Hemorrhagic lesion located on sigmoid colon in the center of the image. (D)Hemorrhagic lesion on broad ligament posterior to round ligament. Lesion is located immediately to right of laparoscopic instrument. (E)Adhesions formed at base of oviduct adjacent to the uterus. Hemorrhagic endometrial lesions located at left of image with filmy adhesions. (F)Filmy adhesions and hemorrhagic lesion located at distal portion of oviduct.
Figure 2
Figure 2. Schematic classification examples of extent and location of endometriosis
Adapted from the Revised American Society for Reproductive Medicine Classification of Endometriosis (1996).
See this image and copyright information in PMC

References

    1. Ailawadi RK, Jobanpufra S, Kataria M, Gurates B, Bulun SE. Treatment of endometriosis and chronic pelvic pain with Letrozole and norethindrone acetate: A pilot study. Fertility and Sterility. 2004;81(2):290–296. - PubMed
    1. Alford D. Nursing care of the patient with endometriosis. Nursing Clinics of North America. 1968;3(2):217–227. - PubMed
    1. American Society for Reproductive Medicine. Revised American society for reproductive medicine classification of endometriosis: 1996. Fertility and Sterility. 1996;67(5):817–821. - PubMed
    1. American Society for Reproductive Medicine. Endometriosis and infertility. Fertility and Sterility. 2006;86(4):156–160. - PubMed
    1. Attar E, Bulun SE. Aromatase inhibitors: The next generation of therapeutics for endometriosis? Fertility and Sterility. 2006;85(5):1307–1318. - PubMed

Publication types

Grants and funding