Central changes associated with chronic pelvic pain and endometriosis
Jennifer Brawn1, Matteo Morotti2, Krina T Zondervan3
1Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK jennifer.brawn@ndcn.ox.ac.uk.
Human Reproduction Update
|June 13, 2014
Summary
Chronic pelvic pain (CPP) involves central nervous system (CNS) changes, impacting pain perception and potentially leading to other chronic conditions. Treatments targeting the CNS may help manage CPP symptoms.
Area of Science:
- Neuroscience
- Pain Medicine
- Gynecology
Background:
- Chronic pelvic pain (CPP) affects 1 million women in the UK, often with pain disproportionate to identified pathology.
- Chronic pain conditions are linked to structural and functional alterations in the central nervous system (CNS).
Purpose of the Study:
- To review the evidence for central nervous system (CNS) changes in women experiencing chronic pelvic pain (CPP).
Main Methods:
- A literature search was conducted to identify relevant studies on CPP and CNS alterations.
- This review is not a systematic review.
Main Results:
- CPP is associated with central changes mirroring those in other chronic pain conditions.
- Observed changes include altered responses to noxious stimuli, structural brain modifications, dysregulation of the hypothalamic-pituitary-adrenal axis and autonomic nervous system (ANS), and psychological distress.
Conclusions:
- Significant central changes are evident in women with CPP compared to pain-free individuals.
- These CNS alterations may worsen CPP symptoms and increase susceptibility to other chronic conditions.
- Adjunctive therapies targeting the CNS are supported for managing CPP.
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