Chronic Pelvic Pain in Women
Linda M Speer1, Saudia Mushkbar1, Tara Erbele1
1University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA.
American Family Physician
|March 2, 2016
Summary
Chronic pelvic pain in women is a complex condition often lacking a clear cause. Management requires a patient-centered, biopsychosocial approach, as curative treatments are limited.
Area of Science:
- Gynecology
- Pain Management
- Women's Health
Background:
- Chronic pelvic pain (CPP) in women is defined as persistent, noncyclic pain lasting over six months.
- It's often linked to functional somatic pain syndromes and mental health disorders.
- Specific etiology is frequently unidentified, complicating diagnosis and treatment.
Purpose of the Study:
- To provide an overview of the definition, diagnosis, and management of chronic pelvic pain in women.
- To highlight the challenges in finding curative treatments and the importance of a comprehensive approach.
Main Methods:
- Diagnosis relies on detailed patient history and physical examination.
- Pelvic ultrasonography is used to exclude anatomical abnormalities.
- Laparoscopy may be indicated for endometriosis evaluation in severe cases.
Main Results:
- Evidence-based therapies are limited, and curative treatment is elusive.
- A biopsychosocial approach is recommended, addressing identifiable conditions like endometriosis, interstitial cystitis, and depression.
- Medications such as depot medroxyprogesterone, gabapentin, NSAIDs, and GnRH agonists may be beneficial.
Conclusions:
- CPP management necessitates a collaborative, patient-centered strategy.
- Pelvic floor physical therapy, behavioral therapy, and neuromodulation are potential therapeutic options.
- Hysterectomy is a last resort for uterine-origin pain, with variable success rates.
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