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13 June 2005
Endometriosis Sends Mixed Messages On Pain 
Researchers say that women suffering from endometriosis often report having several types of chronic pain because their abnormal growths develop a new nerve supply. Researcher Karen Berkley, from Florida State University, led a study that showed that endometrial cysts become supplied by sympathetic and sensory nerves that could contribute to both the different types of pain associated with endometriosis and the body's ability to maintain the disease. Berkley said that the new nerves likely sprout from those that supply the blood vessels that grow along with, and nourish, the cysts. Endometriosis is thought to occur when cells from the lining of the uterus escape into the pelvic cavity during menstruation and attach themselves to the outside of the uterus, ovaries or other organs in the abdomen. The cells can develop into growths or cysts that impact fertility and may cause severe menstrual cramps and other pelvic pains. The new findings, published in the journal Science, were initially drawn from research with rats but have now been replicated on human tissue. "It's been a mystery why there is such a co-occurrence between endometriosis and other painful conditions we wouldn't think would be related - irritable bowel syndrome, interstitial cystitis and even migraines," Berkley said. "It may happen in part because this new nerve supply comes into the central nervous system and interacts with information coming from other organs, such as the colon and bladder." The types of nerves that develop in the cysts, the agents that activate them, the sites in the central nervous system where the nerves deliver information and how the information is modulated by estrogen all influence how the disease will manifest itself, the researchers said. The variability of the nerve supply of the cysts in different individuals may help explain why symptoms and severity of pain vary so greatly in women who have endometriosis, according to Berkley.
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