Chronic pelvic pain in women of reproductive and post‐reproductive age: a population‐based study

Abimbola Ayorinde, Siladitya Bhattacharya, Katie L. Druce, Gareth T. Jones, Gary J. Macfarlane
In: European Journal of Pain · 2016 · vol. 21(3) , pp. 445–455 · doi:10.1002/ejp.938 · PMID:27634190 · W2520039488
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This population-based study found chronic pelvic pain in 14.8% of adult women, more common in reproductive-aged women, and identified two subgroups based on psychosocial distress.

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This population-based cross-sectional postal survey of 5300 randomly selected women aged ≥25 years in the Grampian region (n=2088 responders) examined prevalence of chronic pelvic pain (CPP), associated pregnancy-related and psychosocial factors, and whether distinct CPP subgroups existed. CPP was reported by 14.8% and was more strongly associated with being of reproductive age, multiple non-pain somatic symptoms, fatigue, and depression; a reported interaction suggested heightened somatic awareness may relate more to CPP in older women. Cluster analysis identified two CPP subgroups distinguished by low/little versus high psychosocial distress. The study’s main limitation is its cross-sectional design and reliance on self-reported survey data. This paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

BACKGROUND: Epidemiological studies on chronic pelvic pain (CPP) have focused on women of reproductive age. We aimed to determine the prevalence of chronic pelvic pain (CPP) in adult women and the differences in associated factors among women of reproductive age and older women. In addition, to determine whether distinct subgroups existed among CPP cases. METHODS: A cross-sectional postal survey was conducted among 5300 randomly selected women aged ≥25 years resident in the Grampian region, UK. Multivariable logistic regression was used to determine pregnancy-related and psychosocial factors associated with CPP. To identify subgroups of CPP cases, we performed cluster analysis using variables of pain severity, psychosocial factors and pain coping strategies. RESULTS: Of 2088 participants, 309 (14.8%) reported CPP. CPP was significantly associated with being of reproductive age (odds ratios (OR) 2.43, 95% CI 1.69-3.48), multiple non-pain somatic symptoms (OR 3.58 95% CI 2.23-5.75), having fatigue (OR mild 1.74 95% CI 1.24-2.44, moderate/severe 1.82, 95% CI 1.25-2.63) and having depression (OR 1.61, 95% CI 1.09-2.38). CPP was less associated with multiple non-pain somatic symptoms in women of reproductive age compared to older women (interaction OR 0.51, 95% CI 0.28-0.92). We identified two clusters of CPP cases; those having little/no psychosocial distress and those having high psychosocial distress. CONCLUSION: CPP is common in both age groups, though women of reproductive age are more likely to report it. Heightened somatic awareness may be more strongly associated with CPP in older women. There are distinct groups of CPP cases characterized by the absence/presence of psychosocial distress. SIGNIFICANCE: Heightened somatic awareness may be more strongly associated with CPP in women of post-reproductive years compared to women of reproductive years. Two subgroups of CPP cases can be differentiated by the absence/presence of psychosocial distress suggesting that stratified management approach may be more efficient.
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Abstract

BACKGROUND: Epidemiological studies on chronic pelvic pain (CPP) have focused on women of reproductive age. We aimed to determine the prevalence of chronic pelvic pain (CPP) in adult women and the differences in associated factors among women of reproductive age and older women. In addition, to determine whether distinct subgroups existed among CPP cases.

Methods

A cross-sectional postal survey was conducted among 5300 randomly selected women aged ≥25 years resident in the Grampian region, UK. Multivariable logistic regression was used to determine pregnancy-related and psychosocial factors associated with CPP. To identify subgroups of CPP cases, we performed cluster analysis using variables of pain severity, psychosocial factors and pain coping strategies.

Results

Of 2088 participants, 309 (14.8%) reported CPP. CPP was significantly associated with being of reproductive age (odds ratios (OR) 2.43, 95% CI 1.69-3.48), multiple non-pain somatic symptoms (OR 3.58 95% CI 2.23-5.75), having fatigue (OR mild 1.74 95% CI 1.24-2.44, moderate/severe 1.82, 95% CI 1.25-2.63) and having depression (OR 1.61, 95% CI 1.09-2.38). CPP was less associated with multiple non-pain somatic symptoms in women of reproductive age compared to older women (interaction OR 0.51, 95% CI 0.28-0.92). We identified two clusters of CPP cases; those having little/no psychosocial distress and those having high psychosocial distress.

Conclusion

CPP is common in both age groups, though women of reproductive age are more likely to report it. Heightened somatic awareness may be more strongly associated with CPP in older women. There are distinct groups of CPP cases characterized by the absence/presence of psychosocial distress. SIGNIFICANCE: Heightened somatic awareness may be more strongly associated with CPP in women of post-reproductive years compared to women of reproductive years. Two subgroups of CPP cases can be differentiated by the absence/presence of psychosocial distress suggesting that stratified management approach may be more efficient. | Original language | English | |---|---| | Pages (from-to) | 445-455 | | Number of pages | 11 | | Journal | European journal of pain (London, England) | | Volume | 21 | | Issue number | 2 | | Early online date | 15 Sept 2016 | | DOIs | | | Publication status | Published - 9 Feb 2017 | Fingerprint Dive into the research topics of 'Chronic pelvic pain in women of reproductive and post-reproductive age: a population-based study'. Together they form a unique fingerprint.Cite this - APA - Author - BIBTEX - Harvard - Standard - RIS - Vancouver

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