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Review
. 2021 Sep 1:3:729642.
doi: 10.3389/frph.2021.729642. eCollection 2021.

Peripheral, Central, and Cross Sensitization in Endometriosis-Associated Pain and Comorbid Pain Syndromes

Helen C McNamara  1 , Helena C Frawley  1   2   3 , Jacqueline F Donoghue  1   4 , Emma Readman  3   4 , Martin Healey  1   4 , Lenore Ellett  3   4 , Charlotte Reddington  1   3   4 , Lauren J Hicks  1 , Keryn Harlow  3 , Peter A W Rogers  1   4 , Claudia Cheng  1   4
Affiliations
Review

Peripheral, Central, and Cross Sensitization in Endometriosis-Associated Pain and Comorbid Pain Syndromes

Helen C McNamara et al. Front Reprod Health. .

Abstract

Endometriosis-associated pain and the mechanisms responsible for its initiation and persistence are complex and difficult to treat. Endometriosis-associated pain is experienced as dysmenorrhea, cyclical pain related to organ function including dysuria, dyschezia and dyspareunia, and persistent pelvic pain. Pain symptomatology correlates poorly with the extent of macroscopic disease. In addition to the local effects of disease, endometriosis-associated pain develops as a product of peripheral sensitization, central sensitization and cross sensitization. Endometriosis-associated pain is further contributed to by comorbid pain conditions, such as bladder pain syndrome, irritable bowel syndrome, abdomino-pelvic myalgia and vulvodynia. This article will review endometriosis-associated pain, its mechanisms, and its comorbid pain syndromes with a view to aiding the clinician in navigating the literature and terminology of pain and pain syndromes. Limitations of our current understanding of endometriosis-associated pain will be acknowledged. Where possible, commonalities in pain mechanisms between endometriosis-associated pain and comorbid pain syndromes will be highlighted.

Keywords: central sensitization; cross sensitization; endometriosis; peripheral sensitization; persistent pelvic pain.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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