Changes in Brain Structure
As discussed in 'The Body', endometriosis lesions and inflammation contribute to pain. However, research has shown that certain changes in the brain structure also play an important role in feeling pain. Researchers found lower levels of grey matter in the part of the brain involved within feeling pain among people with endometriosis that feel chronic pain compared to those that do not feel chronic pain1, 2. This means that changes in the brain structure may also contribute to feeling pain separate from the endometriosis lesions.
Gate Control Theory
A person’s thoughts and emotions can change how open or closed this spinal gate is. Someone who experiences pain might experience negative thoughts and emotions. This might change the spinal gate to be more open, which allows more pain messages to get through to the brain. This increases the chance that they might feel more pain.
This is real pain. It is not in your head. Pain can be changed.
- As-Sanie S, Harris RE, Napadow V, Kim J, Neshewat G, Kairys A, Williams D, Clauw DJ, Schmidt-Wilcke T. Changes in regional gray matter volume in women with chronic pelvic pain: a voxel-based morphometry study. Pain. 2012 May;153(5):1006-14. doi: 10.1016/j.pain.2012.01.032
- As-Sanie S, Kim J, Schmidt-Wilcke T, Sundgren PC, Clauw DJ, Napadow V, Harris RE. Functional Connectivity is Associated With Altered Brain Chemistry in Women With Endometriosis-Associated Chronic Pelvic Pain. J Pain. 2016 Jan;17(1):1-13. doi: 10.1016/j.jpain.2015.09.008.
- Trachsel LA, Cascella M. Pain Theory. [Updated 2020 Jul 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK545194/