Chronic pelvic pain

Mary Ann Lumsden, Margaret Rees
In: Menstrual Problems for the MRCOG and Beyond · 2014 · pp. 103–114 · doi:10.1017/cbo9781107445208.010 · W2489362082
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This paper reviews the causes, presentation, investigation, and management of menstrual problems including heavy bleeding, premenstrual disorders, pelvic pain, and dysmenorrhea across a woman's reproductive life.

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Abstract

This introduction discusses the aetiology of menstrual problems, their presentation and investigation as well as medical and surgical management. Specific problems such as fibroid-associated bleeding, adolescent and perimenopausal bleeding and breakthrough bleeding are covered, as are other critically important problems such as premenstrual disorders, pelvic pain and dysmenorrhoea. The most common presenting menstrual problem is heavy menstrual bleeding (HMB). A woman's approach to her periods will vary through her reproductive life. After childbearing is completed, the view of the menses will alter dramatically. The longest intermenstrual interval occurs at the menarche. Menstrual irregularity is most likely to occur at the extremes of reproductive life, the incidence of anovulation increasing as the menopause approaches. Classical primary spasmodic dysmenorrhoea occurs at the onset of the menses and gets better after 1 or 2 days, whereas secondary dysmenorrhoea tends to start prior to the menses and worsens as it proceeds.
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- Menstrual Problems for the MRCOG and Beyond - Series page - Menstrual Problems for the MRCOG and Beyond - Copyright page - Contents - Abbreviations - Preface - Editors - Contributors - 1 Introduction - 2 Excessive menstrual bleeding - 3 Investigation - 4 Medical management of excessive menstrual bleeding - 5 Surgical management of menstrual problems - 6 Uterine fibroids and heavy menstrual bleeding - 7 Dysmenorrhoea - 8 Endometriosis - 9 Chronic pelvic pain - 10 Delayed menarche - 11 Premature ovarian failure - 12 Polycystic ovary syndrome - 13 Premenstrual syndrome - Index Published online by Cambridge University Press: 05 June 2014 Book contents - Menstrual Problems for the MRCOG and Beyond - Series page - Menstrual Problems for the MRCOG and Beyond - Copyright page - Contents - Abbreviations - Preface - Editors - Contributors - 1 Introduction - 2 Excessive menstrual bleeding - 3 Investigation - 4 Medical management of excessive menstrual bleeding - 5 Surgical management of menstrual problems - 6 Uterine fibroids and heavy menstrual bleeding - 7 Dysmenorrhoea - 8 Endometriosis - 9 Chronic pelvic pain - 10 Delayed menarche - 11 Premature ovarian failure - 12 Polycystic ovary syndrome - 13 Premenstrual syndrome - Index Chronic pelvic pain (CPP) may profoundly affect women's ability to function normally in their various roles. Chronic pain may damage their ability to care for their children or maintain social networks, leading to relationship breakdown and loss of quality of life. Factors such as depression and sleep disturbance might reasonably be expected to affect the pain experience but it is increasingly apparent that other factors within the central nervous system will also modify the experience of chronic pain. The contributory factors in the genesis of CPP are gynaecological, bowel-related, bladder-related, musculoskeletal, neurological, and psychological. In women of reproductive age, pelvic pain alone is very rarely a presenting symptom of sinister pathology, but some red flag symptoms might warrant a more urgent approach. Diagnostic laparoscopy may be useful particularly if the woman is concerned about fertility. Additionally, simple assessment often from the patient history can identify therapeutic opportunities. - Type - Chapter - Information - Menstrual Problems for the MRCOG and Beyond , pp. 103 - 114Publisher: Cambridge University PressPrint publication year: 2014 Accessibility compliance for the HTML of this chapter is currently unknown and may be updated in the future. To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle. Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply. Find out more about the Kindle Personal Document Service. - Chronic pelvic pain - Book: Menstrual Problems for the MRCOG and Beyond - Online publication: 05 June 2014 To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox. - Chronic pelvic pain - Book: Menstrual Problems for the MRCOG and Beyond - Online publication: 05 June 2014 To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive. - Chronic pelvic pain - Book: Menstrual Problems for the MRCOG and Beyond - Online publication: 05 June 2014

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