Could chronic pelvic pain be a functional somatic syndrome?
John W Warren1, Vadim Morozov, Fred M Howard
1Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
American Journal of Obstetrics and Gynecology
|May 31, 2011
Summary
Chronic pelvic pain (CPP) in women often lacks a clear cause, even with pelvic pathology. Research suggests CPP may share mechanisms with functional somatic syndromes, potentially originating outside the pelvis.
Area of Science:
- Gynecology
- Pain Medicine
- Medical Research
Background:
- The etiology of noncyclical chronic pelvic pain (CPP) remains unknown in a significant portion of women.
- Identifiable pelvic pathology does not consistently correlate with CPP, and common findings like endometriosis and adhesions have limited association with its prevalence.
- CPP shares characteristics with functional somatic syndromes, such as prominent pain and comorbidity, suggesting overlapping pathophysiological pathways.
Purpose of the Study:
- To explore the potential convergence of research trajectories between chronic pelvic pain and functional somatic syndromes.
- To investigate the hypothesis that CPP in some women may stem from pathologic mechanisms primarily located outside the pelvis.
- To identify novel areas for the exploration and treatment of chronic pelvic pain.
Main Methods:
- Comparative analysis of epidemiological studies on chronic pelvic pain, endometriosis, and adhesions.
- Review of research methodologies applied to functional somatic syndromes, focusing on local and systemic pathogenetic investigations.
- Conceptual synthesis of findings to identify converging research themes between CPP and functional somatic syndromes.
Main Results:
- A substantial percentage of women with CPP have no identifiable pelvic pathology, and the link between existing pathology and pain is often unclear.
- Epidemiological data indicate that endometriosis and adhesions do not significantly increase the likelihood of experiencing CPP.
- Shared clinical features and comorbidities between CPP and functional somatic syndromes suggest a potential commonality in underlying mechanisms.
Conclusions:
- The research pathways for functional somatic syndromes and CPP appear to be converging.
- This convergence may unveil a crucial extra-pelvic pathologic mechanism contributing to CPP in some women.
- Identifying these extra-pelvic mechanisms could revolutionize the exploration and treatment strategies for chronic pelvic pain.
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