Evidence map›Paper›PMID 21106492›Full record

ReviewHuman reproduction update

Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications.

Pamela Stratton, Karen J Berkley

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Human reproduction update. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 157 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
157citing papers in PubMed, 10 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

157 citing papers in PubMed, 10 syntheses or guidelines pooled it.

  1. Pooled it
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  4. Gonadotropin-releasing hormone analogues for endometriosis.The Cochrane database of systematic reviews · 2023
    Pooled it
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  11. Trial
  12. Psychological interventions improve quality of life despite persistent pain in endometriosis: results of a 3-armed randomized controlled trial.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2023
    Trial
  13. Antioxidant supplementation reduces endometriosis-related pelvic pain in humans.Translational research : the journal of laboratory and clinical medicine · 2013
    Trial
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  16. Review
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  20. Management of bowel dysfunction after pelvic surgery for endometriosis.International journal of colorectal disease · 2026
    Review

97 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Pamela StrattonProgram in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Development, National Institutes of Health, Bldg. 10, CRC, RM 1-3140, 10 Center Dr. MSC 1109, Bethesda, MD 20892-1109 USA. strattop@mail.nih.gov
Karen J Berkley

Funding

Reproductive Endocrinology And Infertility Clinical Training ProgramZIEHD008737 · NICHD · EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT · PI HILL, MICAH · 2011 to 2025
$24.0M
SENSORY INNERVATION OF PELVIC ORGANSR01NS011892 · NINDS · FLORIDA STATE UNIVERSITY · PI BERKLEY, KAREN J · 1985 to 2011
$2.3M
Neural Immune and Genetic Influences on Chronic Pelvic Pain and EndometriosisZIAHD008769 · NICHD · EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT · PI STRATTON, PAMELA · 2009 to 2016
$2.1M
Uterus &Colon Influences on Bladder Function in FemalesR21DK063937 · NIDDK · FLORIDA STATE UNIVERSITY · PI BERKLEY, KAREN J · 2003 to 2004
$287k
Intramural NIH HHSNIDDK NIH HHS R21 DK063937NINDS NIH HHS R01 NS011892NINDS NIH HHS R01 NS11892
6 · The paper itself

Abstract

backgroundMany clinicians and patients believe that endometriosis-associated pain is due to the lesions. Yet causality remains an enigma, because pain symptoms attributed to endometriosis occur in women without endometriosis and because pain symptoms and severity correlate poorly with lesion characteristics. Most research and reviews focus on the lesions, not the pain. This review starts with the recognition that the experience of pain is determined by the central nervous system (CNS) and focuses on the pain symptoms.

methodsComprehensive searches of Pubmed, Medline and Embase were conducted for current basic and clinical research on chronic pelvic pain and endometriosis. The information was mutually interpreted by a basic scientist and a clinical researcher, both in the field of endometriosis. The goal was to develop new ways to conceptualize how endometriosis contributes to pain symptoms in the context of current treatments and the reproductive tract.

resultsEndometriotic lesions can develop their own nerve supply, thereby creating a direct and two-way interaction between lesions and the CNS. This engagement provides a mechanism by which the dynamic and hormonally responsive nervous system is brought directly into play to produce a variety of individual differences in pain that can, in some women, become independent of the disease itself.

conclusionsMajor advances in improving understanding and alleviating pain in endometriosis will likely occur if the focus changes from lesions to pain. In turn, how endometriosis affects the CNS would be best examined in the context of mechanisms underlying other chronic pain conditions.

Indexed as

AnimalsCentral Nervous SystemEndometriosisEndometriumFemaleHumansMenstruation DisturbancesPain MeasurementPelvic PainPregnancyPregnancy ComplicationsRatsUterine Diseases

Identifiers

PMID21106492
PMCPMC3072022

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.