Endometriosis-associated pain syndrome: a nurse-led approach

Abstract

Endometriosis is an enigmatic disease and its fundamental cause is still unknown. Endometriosisassociated pain syndrome is a common problem; it is underdiagnosed and patients suffering from the syndrome are rarely seen in specialist pain clinics. The correlation between the extent of the disease and pain is weak. Endometriosis-associated pain syndrome may be cyclical or persistent and the pain may radiate to other pelvic organs. Optimum treatment is timely intervention using a multidisciplinary approach.

Constellations of pain: a qualitative study of the complexity of women’s endometriosis-related pain

“…28 We also found that some women experienced constant pain that increased in intensity during menstruation and for others pain started as cyclical but worsened to be more severe, 33 persistent and pervasive, which has been linked to poor quality of life. 47 Research has suggested that experiencing pain may lead to sensitisation of the nervous system 12,13,48 recognised as a reason for pain to become more pervasive over time 49 however, participants believed that their endometriosis was worsening.…”

“…9 Pain is one of the most common symptoms of endometriosis, along with fatigue, abnormal excessive menstrual flow (menorrhagia) and infertility. [9][10][11] Endometriosis pain often continues even after treatment 12,13 and impacts quality of life [14][15][16] including affecting identity, social and family life, sexual quality of life, [17][18][19][20][21][22] ability to work, 15,23 mental health, 21,24,25 and causing disability, 16,26,27 which Hallståm and colleagues referred to as a ruined life. 28 Dealing with these consequences and feelings of difference from others mean women struggle to create a sense of coherence across different aspects of their life 28 which can result in poor mental health including anxiety and depression.…”

‘ReConnect’: a model for working with persistent pain patients on improving sexual relationships

“…21 This is likely to add to low levels of interest in sex and to exacerbate pain during sexual contact, as the pain-mitigating effects of arousal are not experienced. 22 Avoidance of sex, which may be exacerbated by pain-related low mood, can become an established habit over time, 23 along with loss of sexual interest or libido. Partners of those with CPP report feeling tentative about initiating sex for fear of causing pain 7 and so reinforce this cycle.…”

“…Added to this, individuals with CPP may have worries about fertility and managing pregnancy and family life, and so may postpone or avoid family planning, feeling that their hoped-for futures have been blocked by pain, and presenting as highly distressed when they attend the pain clinic. 23 For those not in a current relationship, the loss of confidence in the ability to have sex may lead to the individual avoiding dating, because of anxiety about future embarrassment or rejection. They may deny themselves any possibility of a relationship, either stating openly that this would be impossible, or adjusting their view of the future so that a partner does not feature.…”

Chronic pelvic pain in women with endometriosis and uterine myoma (a review)

“…Нейроваскулярный компонент боли объясняется ветвлением и образованием новых сосудов, а вместе с ними и симпатических нервных волокон, иннервирующих их [15,16]. Теория нейроангиогенеза внутри эктопических очагов также нашла отражение в современных публикациях.…”