Cited by 160Endometriosis Research and TreatmentMenstrual Health and DisordersEctopic Pregnancy Diagnosis and Management

Menstruation pulls the trigger for inflammation and pain in endometriosis

Laux-Biehlmann, Alexis, d’Hooghe, Thomas, Zollner, Thomas M.·2015·Trends in Pharmacological Sciences

Abstract

Endometriosis is a chronic, hormone-dependent, inflammatory disease, characterized by the presence and growth of endometrial tissue outside the uterine cavity. It affects 5-10% of the female population of reproductive age and is frequently associated with moderate to severe pain, subfertility, and a marked reduction in health-related quality of life. Here, we propose a new pathophysiological concept of endometriosis, summarizing recent findings in one unifying picture. We propose menstruating tissue as the trigger for inflammatory pain in endometriosis through the activation of innate immune cells and peripheral nerve endings. We speculate how innovative treatment modalities beyond hormonal treatment will improve patients' lives.

Integrity signals

Registry

Crossref · 10.1016/j.tips.2015.03.004

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108 of 108 references verified0 citation errors · 0 not checkable

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  • Because endometriosis can be found in asymptomatic women, the biochemical pathway of nerve stimulation by menstrual debris does not apply to asymptomatic women, suggesting inflammation from menstruating ectopic foci and menstrual debris may not be the sole cause of pelvic pain.

    “Because endometriosis can be found in asymptomatic women, however, the biochemical pathway of nerve stimulation by the release of damage-associated molecular patterns and pathogen-associated molecular patterns by the menstrual debris (58) does not apply to the asymptomatic women, suggesting that the inflammation caused by ''menstruating'' ectopic foci and menstrual debris may not be the sole cause”

    From Biomarkers in endometriosis: Challenges and opportunities (2017) · cites this paper as [58]

  • The continuous use of OC is suggested to achieve amenorrhea and relieve pain at withdrawal bleeding that may still afflict endometriosis patients using OC cyclically.

    “In particular, the continuous use of OC is suggested to achieve amenorrhea and relieve pain at withdrawal bleeding that may still afflict endometriosis patients using OC cyclically (32,33).”

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Authors
Laux-Biehlmann, A., d’Hooghe, T., & Zollner, T. M.
Affiliations
  • Universitair Ziekenhuis Leuven (BE)
  • Bayer (Germany) (DE)
Corresponding author
Zollner, Thomas M.
Venue
Trends in Pharmacological Sciences
Publisher
Elsevier BV
Published
2015-05
Volume
36
Issue
5
Pages
270-276
ISSN
0165-6147 (ISSN-L)
OpenAlex
W2084007114
Cited by
150
References
109
Citations by year
2026: 10 · 2025: 9 · 2024: 16 · 2023: 19 · 2022: 9 · 2021: 21 · 2020: 16 · 2019: 15 · 2018: 8 · 2017: 12 · 2016: 10 · 2015: 5
FWCI
1.75
Type
journal article
Language
en
Open access
closed
Locations
  • Trends in Pharmacological Sciences (publishedVersion)
  • PubMed (publishedVersion)
Funders
Bayer
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Menstrual Health and Disorders
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
Keywords
endometriosis, menstruation, inflammatory pain, innate immune cells, peripheral nerve endings, pathophysiology, hormone therapy, non-hormonal therapy, chronic inflammation
MeSH terms
Endometriosis, Female, Humans, Inflammation, Menstrual Cycle, Nociceptive Pain

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