Studia Medyczne

Central sensitisation as a mechanism of chronic pain in women with endometriosis – a systematic review of the literature

Julia Słomka 1
,
Anna B. Pilewska-Kozak 2

  1. Department of Coordinated Maternity Care, Medical University of Lublin, Poland

  2. Chair of Obstetrics and Gynaecology, Department Obstetric and Gynaecological Nursing, Faculty of Health Sciences, Medical University of Lublin, Poland

Medical Studies

DOI: https://doi.org/10.5114/ms.2026.162188
Data publikacji online: 2026/06/05
Article file
Central sensitisation.pdf
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  1. Orr NL, Huang AJ, Liu YD, Noga H, Bedaiwy MA, Williams C, Allaire C, Yong PJ. Association of central sensitization inventory scores with pain outcomes after endometriosis surgery. JAMA Netw Open. 2023; 6(2): e230780.
  2. Van Aken M, Oosterman J, Van Rijn T, Woudsma K, Ferdek M, Ruigt G, Kozicz T, Braat D, Peeters A, Nap A. Experimental pain tolerance is decreased and independent of clinical pain intensity in patients with endometriosis. Fertil Steril. 2018; 110(6): 1118-1128.
  3. Ding A, Noga H, Bouchard KN, Bedaiwy MA, Lee C, Allaire C, Orr NL, Yong PJ. Pain with orgasm in endometriosis: potential etiologic factors and clinical correlates. J Sex Med. 2024; 21(9): 807-815.
  4. Tucker DR, Noga HL, Lee C, Chiu DS, Bedaiwy MA, Williams C, Allaire C, Talhouk A, Yong PJ. Pelvic pain comorbidities associated with quality of life after endometriosis surgery. Am J Obstet Gynecol. 2023; 229(2): 147.e1-147.e20.
  5. Gentles A, Goodwin E, Bedaiwy Y, Marshall N, Yong PJ. Nociplastic pain in endometriosis: a scoping review. J Clin Med. 2024; 13(24): 7521.
  6. Dolci C, Jean Dit Gautier E, Lannez L, Lebuffe G, Wat- tier JM, Rubod C. Neuropathic-like pain affects pain perception in patients with deep endometriosis: an observational study. Arch Gynecol Obstet. 2025; 312(5): 1789-1797.
  7. Koninckx PR, Meuleman C, Demeyere S, Lesaffre E, Cornillie FJ. Suggestive evidence that pelvic endometriosis is a progressive disease, whereas deeply infiltrating endometriosis is associated with pelvic pain. Fertil Steril. 1991; 55(4): 759-765.
  8. Bedaiwy MA, Alfaraj S, Yong P, Casper R. New developments in the medical treatment of endometriosis. Fertil Steril. 2017; 107(3): 555-565.
  9. Shakiba K, Bena JF, McGill KM, Minger J, Falcone T. Surgical treatment of endometriosis: a 7-year follow-up on the requirement for further surgery. Obstet Gynecol. 2008; 111(6): 1285-1292.
  10. Quintas-Marquès L, Martínez-Zamora MÁ, Camacho M, Gràcia M, Rius M, Ros C, Carrion A, Carmona F. Central sensitization in patients with deep endometriosis. Pain Med. 2023; 24(8): 1005-1007.
  11. Bouko-Levy E, Auditeau E, Margueritte F, Lacorre A, Gauthier T. Prevalence of neuropathic pain in patients with symptomatic endometriosis: assessment using the DN4 score. Eur J Obstet Gynecol Reprod Biol. 2024; 300: 196-201.
  12. Yong PJ, Williams C, Bedaiwy MA, Allaire C. A proposed platform for phenotyping endometriosis-associated pain: unifying peripheral and central pain mechanisms. Curr Obstet Gynecol Rep. 2020; 9(3): 89-97.
  13. Cetera GE, Merli CEM, Boero V, Caia C, Facchin F, Barba­- ra G, Monti E, Vercellini P. Central sensitization in vulvodynia and endometriosis: what have we been overlooking so far? Obstet Gynecol Surv. 2023; 78(12): 745-758.
  14. Orr NL, Wahl KJ, Noga H, Allaire C, Williams C, Bedaiwy MA, Albert A, Smith KB, Yong PJ. Phenotyping sexual pain in endometriosis using the central sensitization inventory. J Sex Med. 2020; 17(4): 761-770.
  15. Stratton P, Khachikyan I, Sinaii N, Ortiz R, Shah J. Association of chronic pelvic pain and endometriosis with signs of sensitization and myofascial pain. Obstet Gynecol. 2015; 125(3): 719-728.
  16. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hróbjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, Stewart LA, Thomas J, Tricco AC, Welch VA, Whiting P, Moher D. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021; 372: n71.
  17. Quintas-Marquès L, Valdés-Bango M, Box C, Gràcia M, Rius M, Carmona F, Martinez-Zamora MA. Multidimensional evaluation of myofascial pelvic pain and other comorbidities in endometriosis patients. J Clin Med. 2025; 14(10): 3455.
  18. Nijs J, Lahousse A, Kapreli E, Bilika P, Saraçoğlu İ, Malfliet A, Coppieters I, De Baets L, Leysen L, Roose E, Clark J, Voogt L, Huysmans E. Nociplastic pain criteria or recognition of central sensitization? Pain phenotyping in the past, present and future. J Clin Med. 2021; 10(15): 3203.
  19. Grundström H, Gerdle B, Alehagen S, Berterö C, Arendt- Nielsen L, Kjølhede P. Reduced pain thresholds and signs of sensitization in women with persistent pelvic pain and suspected endometriosis. Acta Obstet Gynecol Scand. 2019; 98(3): 327-336.
  20. Ping Z, Wen Z, Jinhua L, Jinghe L. Research on central sensitization of endometriosis-associated pain: a systematic review of the literature. J Pain Res. 2019; 12: 1447-1456.
  21. Alves JS, Meneses T, Mariano M, Serra SS, Costa T, Mar- tins JP, Rabishong B, Lima J. Is endometriosis staging related to the type and intensity of patients’ complaints? A systematic review and meta-analysis. J Minim Invasive Gynecol. 2026; 33(5): 505-515.
  22. McNamara HC, Frawley HC, Donoghue JF, Readman E, Healey M, Ellett L, Reddington C, Hicks LJ, Harlow K, Rogers PAW, Cheng C. Peripheral, central, and cross sensitization in endometriosis-associated pain and comorbid pain syndromes. Front Reprod Health. 2021; 3: 729642.
  23. Orr NL, Wahl KJ, Lisonek M, Joannou A, Noga H, Albert A, Bedaiwy MA, Williams C, Allaire C, Yong PJ. Central sensitization inventory in endometriosis. Pain. 2022; 163(2): e234-e245.
  24. Yosef A, Allaire C, Williams C, Ahmed AG, Al-Hussaini T, Abdellah MS, Wong F, Lisonkova S, Yong PJ. Multifactorial contributors to the severity of chronic pelvic pain in women. Am J Obstet Gynecol. 2016; 215(6): 760.e1-760.e14.
Copyright: © 2026 Jan Kochanowski University in Kielce This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (http://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
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