General hypothesis role of the Axon reflex in female chronic pelvic pain. The black lines to the cortex represent afferent visceral nerves which enter the visceral plexuses (VPs) and proceed onwards to a ganglion. The VPs are supported by the lower end of the uterosacral ligaments (USLs), about 2 cm before the USLs insert into the cervix. The red ellipse shows the bunching of the afferent axons in the VPs. In the standing position, each of the component axons in the unsupported VPs (unbroken lines) is stimulated by the force of gravity and they send afferent signals to the cortex. This “bunching” in the ellipse explains the simultaneous relief of several pain centers with the speculum tests and local anesthetic injection into the USLs. Activation of the axon reflex sends antidromic impulses back to the end organ receptors which stimulate an inflammatory reaction which can cause pain.