4. Endometriosis: Pathogenesis and Management of Pain

  1. Paolo Vercellini
  1. Jennifer L. Kulp MD and
  2. A. Arici MD

Published Online: 21 MAR 2011

DOI: 10.1002/9781444391855.ch4

Chronic Pelvic Pain

Chronic Pelvic Pain

How to Cite

Kulp, J. L. and Arici, A. (2011) Endometriosis: Pathogenesis and Management of Pain, in Chronic Pelvic Pain (ed P. Vercellini), Blackwell Publishing Ltd., Oxford, UK. doi: 10.1002/9781444391855.ch4

Editor Information

  1. Istituto “Luigi Mangiagalli”, Fondazione IRCCS Ca' Granda, University of Milan, Italy

Author Information

  1. Yale University School of Medicine, New Haven, Connecticut, USA

Publication History

  1. Published Online: 21 MAR 2011
  2. Published Print: 23 MAR 2011

Book Series:

  1. Gynecology in Practice

Book Series Editors:

  1. Aydin Arici

ISBN Information

Print ISBN: 9781444330663

Online ISBN: 9781444391855



  • Endometriosis: Pathogenesis and Management of Pain;
  • “powder burn”;
  • oral contraceptive pills (OCPs);
  • nonsteroidal anti - inflammatory drugs (NSAIDs);
  • luteinizing hormone (LH);
  • follicle - stimulating hormone (FSH)


Endometriosis is a common condition, especially in women with chronic pelvic pain. The etiology of endometriosis is likely multifactorial, and endometriosis may be due to retrograde menstruation, colemic metaplasia, a dysfunctional immune response and increased inflammation, a genetic predisposition or a population of lesions from stem cells. Symptoms of endometriosis are not specific to the disease, and diagnosis is most accurate when made at the time of laparoscopy. Endometriosis can be treated medically with nonsteroidal anti-inflammatory medications, oral contraceptive pills, danazol, progestins, gonadotropin-releasing hormone agonists, or aromatase inhibitors. Surgical treatment is an option for patients who have failed medical management or who have symptomatic endometriomas.