At this year’s Endometriosis Foundation of America annual Medical Conference and Patient Day, clinicians and researchers argued for treating endometriosis as a nerve‑driven disease rather than solely a gynecologic or hormonal disorder. Speakers linked persistent pain to nerve growth and sensitization and highlighted the vagus nerve as a candidate target for new therapies.
Several presenters described neuroangiogenesis — the paired growth of blood vessels and nerves — as a mechanism that helps lesions survive and generate pain. Dr. Michael Nimaroff of Northwell Health Lenox Hill said hormonal suppression often fails to relieve pain despite shrinking lesions: “If estrogen drives lesion growth and lesion growth drives pain, hormonal suppression should work, but it doesn’t.” The conference emphasized peripheral sensitization (increased receptor sensitivity at lesion sites) and central sensitization (amplified spinal and brain pain signaling) as drivers of chronic, cyclical and non‑cyclical pain.
Surgeons at the meeting stressed presurgical mapping and complete excision to address nerve‑related pain while preserving organ function. Dr. Paulina Carrillo said mapping “is not just a descriptive map; it can guide the treatment plan.” Dr. Seckin reported that using an aqua blue contrast technique to visualize small lesions reduced his five‑year recurrence rate from 16% to nearly 8% after he adopted the method.
Vagus nerve: a therapeutic possibility
Researchers and patient advocates discussed vagus nerve stimulation (VNS) as a potential adjunct for endometriosis pain. Dr. Sun‑Wei Guo of Fudan University noted that existing drugs are not curative and suggested exploring whether VNS could produce lasting symptom relief. Presenters described VNS delivered by implanted or external devices and noted non‑device methods that stimulate the vagus nerve, such as breathwork, humming and cold exposure.
Patient speakers described long diagnostic delays and the emotional toll of invalidation. Dr. Arnold Wilson highlighted depression‑pain cycles that can follow years of being dismissed. Several presenters recommended integrating pain biology with psychosocial care and practical coping tools such as behavioral therapy, sleep and nutrition strategies to improve recovery.
Conference attendees called for more research funding and policy advocacy to advance nerve‑targeted studies, presurgical mapping standards, and trials testing neuromodulation approaches for endometriosis pain.
Photo credit: www.endofound.org
Tags: endometriosis, vagus nerve stimulation, neuroangiogenesis, pain sensitization, excision surgery
Topics: Vagus nerve & taVNS, Neuromodulation, Neuroscience & neuroplasticity