Inflammation and nerve fiber interaction in endometriotic pain

• The pathogenesis of endometriotic pain is not clear.
• Endometriotic lesions are associated with inflammation and nerve growth.
• Production of chronic pain by endometriotic lesions can permanently affect the central nervous system.
• Endometriotic-associated inflammation may interact with the central nervous system to produce endometriotic pain.

Endometriosis is an extremely prevalent estrogen-dependent condition characterized by the growth of ectopic endometrial tissue outside the uterine cavity, and is often presented with severe pain. Although the relationship between lesion and pain remains unclear, nerve fibers found in close proximity to endometriotic lesions may be related to pain. Also, women with endometriosis pain develop central sensitization. Endometriosis creates an inflammatory environment and recent research is beginning to elucidate the role of inflammation in stimulating peripheral nerve sensitization. In this review, we discuss endometriosis-associated inflammation, peripheral nerve fibers, and assess their potential mechanism of interaction. We propose that an interaction between lesions and nerve fibers, mediated by inflammation, may be important in endometriosis-associated pain.