An analysis of the intensity and quality of gynecological pain

It is evident that the pain experience varies qualitatively as well as in intensity. A number of methods to assess both the intensity and quality of pain have been reported. This paper presents the results of a card sort method of pain assessment in the measurement of gynecological pain, which provides a score from 1 to 4 for 10 pain qualities. Factor analysis has identified 3 main clusters or pain dimensions: sensations, reaction and a tiring/duration dimension. Comparative data is presented on 5 main pain types using this method: dysmenorrhea, IUD related pain, IUD insertion pain, postoperative pain and post-partum pain. A total of 232 patients were assessed. The results permit comparisons between pain types for both intensity as well as quality. This distinction may have implications for pain management. Thus although dysmenorrhea and IUD related pain were similar in terms of sensations, dysmenorrhea was rated significantly higher in terms of the reaction component. Similarly, both IUD insertion pain and post-partum pain received high reaction scores. The implications of such a score profile are discussed. Thus, these scores may result from the unexpected nature of the pain sensations rather than their high intensity. In which case inclusion of psychological preparation may have been of benefit. Similarly with pelvic pain of unknown organic origin, substantial relief may be provided by focussing on the reaction component, where this is elevated, and removing the worry surrounding the sensations.