Medical Treatment of Chronic Pelvic Pain

In: Medicines For Women · 2014 · pp. 291–330 · doi:10.1007/978-3-319-12406-3_10 · W261709150
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This chapter reviews medicines used for chronic pelvic pain, emphasizing a biopsychosocial approach and pragmatic care pathways, as traditional disease-based treatments lack strong evidence of effectiveness.

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The paper is a chapter reviewing medical treatments for chronic pelvic pain (CPP), aiming to connect general knowledge about persistent pain mechanisms to pain conditions in gynecology and to outline a pragmatic pathway of care for women, emphasizing that no single medicine works in isolation. It frames CPP management using a biopsychosocial model, arguing that variation in care reflects limited understanding of pain etiology and mechanisms as well as patient responses shaped by environmental, psychological, cognitive, and social influences. A key limitation stated is that evidence for disease-based traditional treatments is weak at best, and the chapter is positioned as an appraisal rather than a new empirical study. Relevance to endometriosis: the chapter is included because it discusses CPP in gynecology and cites literature on endometriosis-related pain, including references such as “Pain and endometriosis” and “The pains of endometriosis,” though the chapter’s main focus is CPP medical treatment within a biopsychosocial framework.

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Abstract

Chronic pelvic pain (CPP) is a common disorder with a significant health burden, yet is poorly understood with regard to its aetiology and management. Traditional treatments for CPP are directed at disease-based pathology; however, the evidence for effectiveness is weak at best. The scope of this chapter is to appraise the reader of the medicines used in CPP and aims to correlate knowledge about persistent pain mechanisms in general and apply that to pain conditions in gynaecology, the most common being CPP. To address this it is essential that the multidimensional management of CPP is emphasised since no medicine can work in isolation; indeed medicines are just one small part of management of these conditions. No matter what the biological cause of the pain the way the person responds and presents is modified by environmental, psychological, cognitive and social influences i.e. the biopsychosocial model. We believe contemporary variation in care is attributed to a poor understanding of this model and the aetiology and mechanisms of CPP. This chapter will advise on a pragmatic pathway of care including the medicines prescribed to women for this condition. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

References

Abou-Setta AM, Houston B, Al-Inany HG, Farquhar C (2013) Levonorgestrel-releasing intrauterine device (LNG-IUD) for symptomatic endometriosis following surgery. Cochrane Database Syst Rev (1):CD005072 Aggarwal V, McBeth J, Zakrzewska J, Lunt M, Macfarlane G (2006) The epidemiology of chronic syndromes that are frequently unexplained: do they have common associated factors? Int J Epidemiol 35:468–476 As-Sanie S, Clevenger LA, Geisser ME, Williams DA, Roth RS (2014). History of abuse and its relationship to pain experience and depression in women with chronic pelvic pain. Am J Obstet Gynecol 210(4):317.e311–317.e318 Atwal G, du Plessis D, Armstrong G, Slade R, Quinn M (2005) Uterine innervation after hysterectomy for chronic pelvic pain with, and without, endometriosis. Am J Obstet Gynecol 193:1650–1655 Baranowski AP, Lee J, Price C, Hughes J, Mahajan RP (2014) Pelvic pain: a pathway for care developed for both men and women by the British Pain Society. Br J Anaesth 112(3):452–459 Bennett MI, Attal N, Backonja MM, Baron R, Bouhassira D, Freynhagen R, Scholz J, Tolle TR, Wittchen H-U, Jensen TS (2007) Using screening tools to identify neuropathic pain. Pain 127(3):199–203 Berkley KJ (2005) A life of pelvic pain. Physiol Behav 86(3):272–280 Berkley KJ, McAllister SL (2011) Don’t dismiss dysmenorrhea! Pain 152(9):1940–1941 Berkley KJ, Rapkin AJ, Papka RE (2005) The pains of endometriosis. Science 308(5728):1587–1589 Bharucha AE, Wald A, Enck P, Rao S (2006) Functional anorectal disorders. Gastroenterology 130(5):1510–1518 Bhide AA, Puccini F, Khullar V, Elneil S, Alessandro Digesu G (2013) Botulinum neurotoxin type A injection of the pelvic floor muscle in pain due to spasticity: a review of the current literature. Int Urogynecol J Pelvic Floor Dysfunct 24(9):1429–1434 Björkman R, Hallman KM, Hedner J, Hedner T, Henning M (1994) Acetaminophen blocks spinal hyperalgesia induced by NMDA and substance P. Pain 57(3):259–264 Boersma K, Linton S (2005) How does persistent pain develop? An analysis of the relationship between psychological variables, pain and function across stages of chronicity. Behav Res Ther 43:1495–1507 Bouhassira D, Attal N, Alchaar H, Boureau F, Brochet B, Bruxelle J, Cunin G, Fermanian J, Ginies P, Grun-Overdyking A, Jafari-Schluep H, Lanteri-Minet M, Laurent B, Mick G, Serrie A, Valade D, Vicaut E (2005) Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4). Pain 114(1–2):29–36 Brandsborg B, Nikolajsen L, Hansen CT, Kehlet H, Jensen TS (2007) Risk factors for chronic pain after hysterectomy: a nationwide questionnaire and database study. Anesthesiology 106(5):1003–1012 Brannstrom M, Enskog A (2002) Leukocyte networks and ovulation. J Reprod Immunol 57(1–2):47–60 Brinkert W, Dimcevski G, Arendt-Nielsen L, Drewes AM, Wilder-Smith OHG (2007) Dysmenorrhoea is associated with hypersensitivity in the sigmoid colon and rectum. Pain 132(Suppl 1):S46–S51 Brown J, Farquhar C (2014) Endometriosis: an overview of Cochrane Reviews. Cochrane Database Syst Rev (3):CD009590 Butrick CW (2009a) Pathophysiology of pelvic floor hypertonic disorders. Obstet Gynecol Clin North Am 36(3):699–705 Butrick CW (2009b) Pelvic floor hypertonic disorders: identification and management. Obstet Gynecol Clin North Am 36(3):707–722 Carr DB, Goudas LC (1999) Acute pain. Lancet 353(9169):2051–2058 Chaparro EL, Wiffen PJ, Moore AR, Gilron I (2012) Combination pharmacotherapy for the treatment of neuropathic pain in adults. Cochrane Database Syst Rev (7):CD008943 Chen R, Cohen LG, Hallett M (2002) Nervous system reorganization following injury. Neuroscience 111(4):761–773 Cheong Y, Stones W (2005) Investigations for chronic pelvic pain. Rev Gynaecol Pract 5(4):227–236 Cheong Y, William Stones R (2006) Chronic pelvic pain: aetiology and therapy. Best Pract Res Clin Obstet Gynaecol 20(5):695–711 Cheong YC, Reading I, Bailey S, Sadek K, Ledger W, Li TC (2014a) Should women with chronic pelvic pain have adhesiolysis? BMC Womens Health 14(1):36 Cheong YC, Smotra G, Williams AC (2014b) Non-surgical interventions for the management of chronic pelvic pain. Cochrane Database Syst Rev (3):CD008797 Choi YK, Kraft N, Zimmerman B, Jackson M, Rao SSC (2008) Fructose intolerance in IBS and utility of fructose-restricted diet. J Clin Gastroenterol 42(3):233–238 Chou R, Fanciullo GJ, Fine PG, Adler JA, Ballantyne JC, Davies P, Donovan MI, Fishbain DA, Foley KM, Fudin J, Gilson AM, Kelter A, Mauskop A, O’Connor PG, Passik SD, Pasternak GW, Portenoy RK, Rich BA, Roberts RG, Todd KH, Miaskowski C (2009) Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain. J Pain 10(2):113–130.e122 Chu MC, Zhang X, Gentzschein E, Stanczyk FZ, Lobo RA (2007) Formation of ethinyl estradiol in women during treatment with norethindrone acetate. J Clin Endocrinol Metabol 92(6):2205–2207 Cicchiello LA, Hamper UM, Scoutt LM (2011) Ultrasound evaluation of gynecologic causes of pelvic pain. Obstet Gynecol Clin North Am 38(1):85–114 Cohen SP, Mao J (2014) Neuropathic pain: mechanisms and their clinical implications. BMJ (Online) 348:f7656 Corrigan R, Derry S, Wiffen PJ, Moore AR (2014) Clonazepam for neuropathic pain and fibromyalgia in adults. Cochrane Database Syst Rev (4):CD009486 Crawford C, Lee C, Bingham J (2014) Sensory art therapies for the self-management of chronic pain symptoms. Pain Med 15:S66–S75 Daniels J, Gray R, Hills RK, Latthe P, Buckley L, Gupta J, Selman T, Adey E, Xiong T, Champaneria R, Lilford R, Khan KS (2009) Laparoscopic uterosacral nerve ablation for alleviating chronic pelvic pain: a randomized controlled trial. JAMA 302(9):955–961 Davis NF, Brady CM, Creagh T (2014) Interstitial cystitis/painful bladder syndrome: epidemiology, pathophysiology and evidence-based treatment options. Eur J Obstet Gynecol Reprod Biol 175(1):30–37 de Leon-Casasola OA (2007) Multimodal approaches to the management of neuropathic pain: the role of topical analgesia. J Pain Symptom Manage 33(3):356–364 De Souza Montenegro MLL, Mateus-Vasconcelos ECL, Silva JCRE, Nogueira AA, Dos Reis FJC, Poli Neto OB (2010) Importance of pelvic muscle tenderness evaluation in women with chronic pelvic pain. Pain Med 11(2):224–228 D’Hooghe TM, Debrock S (2002) Endometriosis, retrograde menstruation and peritoneal inflammation in women and in baboons. Hum Reprod Update 8(1):84–88 Drossman DA (2006) The functional gastrointestinal disorders and the Rome III process. Gastroenterology 130(5):1377–1390 Dworkin RH, O’Connor AB, Backonja M, Farrar JT, Finnerup NB, Jensen TS, Kalso EA, Loeser JD, Miaskowski C, Nurmikko TJ, Portenoy RK, Rice ASC, Stacey BR, Treede R-D, Turk DC, Wallace MS (2007) Pharmacologic management of neuropathic pain: evidence-based recommendations. Pain (in press), Corrected Proof: 13 Dworkin RH, O’Connor AB, Audette J, Baron R, Gourlay GK, Haanpää ML, Kent JL, Krane EJ, LeBel AA, Levy RM, Mackey SC, Mayer J, Miaskowski C, Raja SN, Rice ASC, Schmader KE, Stacey B, Stanos S, Treede RD, Turk DC, Walco GA, Wells CD (2010) Recommendations for the pharmacological management of neuropathic pain: an overview and literature update. Mayo Clin Proc 85(Suppl 3):S3–S14 Eccleston C, Morley SJ, Williams AC (2013) Psychological approaches to chronic pain management: evidence and challenges. Br J Anaesth 111(1):59–63 Evans S, Moalem-Taylor G, Tracey D (2007) Pain and endometriosis. Pain 132:S22–S25 Farquhar C, Latthe P (2006) Chronic pelvic pain: aetiology and therapy. Rev Gynaecol Perinatal Pract 6(3–4):177–184 Farquhar CM, Harvey SA, Yu Y, Sadler L, Stewart AW (2006) A prospective study of 3 years of outcomes after hysterectomy with and without oophorectomy. Am J Obstet Gynecol 194(3):711–717 Fedewa A, Rao SSC (2014) Dietary fructose intolerance, fructan intolerance and FODMAPs. Curr Gastroenterol Rep 16(1):370 Finan PH, Goodin BR, Smith MT (2013) The association of sleep and pain: an update and a path forward. J Pain 14(12):1539–1552 Finnerup NB, Sindrup SH, Jensen TS (2010) The evidence for pharmacological treatment of neuropathic pain. Pain 150(3):573–581 FitzGerald MP, Brensinger C, Brubaker L, Propert K, I. S. Group (2006) What is the pain of interstitial cystitis like? Int Urogynecol J 17(1):69–72 Foldvary-Schaefer N, De Leon Sanchez I, Karafa M, Mascha E, Dinner D, Morris HH (2002) Gabapentin increases slow-wave sleep in normal adults. Epilepsia 43(12):1493–1497 Foster HE Jr, Hanno PM, Nickel JC, Payne CK, Mayer RD, Burks DA, Yang CC, Chai TC, Kreder KJ, Peters KM, Lukacz ES, FitzGerald MP, Cen L, Landis JR, Propert KJ, Yang W, Kusek JW, Nyberg LM (2010) Effect of amitriptyline on symptoms in treatment naïve patients with interstitial cystitis/painful bladder syndrome. J Urol 183(5):1853–1858 Gatchel RJ, Peng YB, Peters ML, Fuchs PN, Turk DC (2007) The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychol Bull 133(4):581–624 Gebhart GF (2004) Descending modulation of pain. Neurosci Biobehav Rev 27(8):729–737 Giamberardino MA, Costantini R, Affaitati G, Fabrizio A, Lapenna D, Tafuri E, Mezzetti A (2010) Viscero-visceral hyperalgesia: characterization in different clinical models. Pain 151(2):307–322 Gibson PR, Shepherd SJ (2010) Evidence-based dietary management of functional gastrointestinal symptoms: the FODMAP approach. J Gastroenterol Hepatol (Australia) 25(2):252–258 Gill D, Derry S, Wiffen PJ, Moore AR (2014) Valproic acid and sodium valproate for neuropathic pain and fibromyalgia in adults. Cochrane Database Syst Rev (2):CD009183 Gilron I, Jensen TS, Dickenson AH (2013) Combination pharmacotherapy for management of chronic pain: from bench to bedside. Lancet Neurol 12(11):1084–1095 Giudice LC (2010) Endometriosis. N Engl J Med 362(25):2389–2398 Giudice LC, Kao LC (2004) Endometriosis. Lancet 364(9447):1789–1799 Gordh TE, Stubhaug A, Jensen TS, Arnèr S, Biber B, Boivie J, Mannheimer C, Kalliomäki J, Kalso E (2008) Gabapentin in traumatic nerve injury pain: a randomized, double-blind, placebo-controlled, cross-over, multi-center study. Pain 138(2):255–266 Grace VM (2001) Chronic pelvic pain: sociocultural perspectives. Royal College of Obstetricians and Gynaecologists Press, London Grace VM, Zondervan KT (2004) Chronic pelvic pain in New Zealand: prevalence, pain severity, diagnoses and use of the health services. Aust NZ J Public Health 28(4):369–375 Gunter J (2003) Chronic pelvic pain: an integrated approach to diagnosis and treatment. Obstet Gynecol Surv 58(9):615–623 Gunter J (2007) Vulvodynia: new thoughts on a devastating condition. Obstet Gynecol Surv 62:812–819 Hartmann KE, Ma C, Lamvu GM, Langenberg PW, Steege JF, Kjerulff KH (2004) Quality of life and sexual function after hysterectomy in women with preoperative pain and depression. Obstet Gynecol 104(4):701–709 Hibner M, Desai N, Robertson LJ, Nour M (2010) Pudendal neuralgia. J Minim Invasive Gynecol 17(2):148–153 Howard F (2003) Chronic pelvic pain. Obstet Gynecol 101(3):594–611 Hutchinson MR, Loram LC, Zhang Y, Shridhar M, Rezvani N, Berkelhammer D, Phipps S, Foster PS, Landgraf K, Falke JJ, Rice KC, Maier SF, Yin H, Watkins LR (2010) Evidence that tricyclic small molecules may possess toll-like receptor and myeloid differentiation protein 2 activity. Neuroscience 168(2):551–563 Iacovides S, Baker FC, Avidon I, Bentley A (2013) Women with dysmenorrhea are hypersensitive to experimental deep muscle pain across the menstrual cycle. J Pain 14(10):1066–1076 Jensen TS, Baron R (2003) Translation of symptoms and signs into mechanisms in neuropathic pain. Pain 102(1–2):1–8 Kainu JP, Sarvela J, Tiippana E, Halmesmäki E, Korttila KT (2010) Persistent pain after caesarean section and vaginal birth: a cohort study. Int J Obstet Anesth 19(1):4–9 Kehlet H, Jensen TS, Woolf CJ (2006) Persistent postsurgical pain: risk factors and prevention. Lancet 367(9522):1618–1625 Kelly RW, King AE, Critchley HOD (2002) Inflammatory mediators and endometrial function–focus on the perivascular cell. J Reprod Immunol 57(1–2):81–93 Kennedy C, Nygaard I, Saftlas A, Burns T, Torner J, Galask R (2005) Vulvar disease: a pelvic floor pain disorder? Am J Obstet Gynecol 192:1829–1835 Kuhl H (2005) Pharmacology of estrogens and progestogens: influence of different routes of administration. Climacteric 8(Suppl 1):3–63 Labat JJ, Riant T, Robert R, Amarenco G, Lefaucheur JP, Rigaud J (2008) Diagnostic criteria for pudendal neuralgia by pudendal nerve entrapment (Nantes criteria). Neurourol Urodyn 27(4):306–310 Lamvu G, Williams R, Zolnoun D, Wechter ME, Shortliffe A, Fulton G, Steege JF (2006) Long-term outcomes after surgical and nonsurgical management of chronic pelvic pain: one year after evaluation in a pelvic pain specialty clinic. Am J Obstet Gynecol 195(2):591–598, discussion 598–600 Landmark T, Romundstad P, Borchgrevink PC, Kaasa S, Dale O (2011) Associations between recreational exercise and chronic pain in the general population: evidence from the HUNT 3 study. Pain 152(10):2241–2247 Latremoliere A, Woolf CJ (2009) Central sensitization: a generator of pain hypersensitivity by central neural plasticity. J Pain 10(9):895–926 Latthe P, Latthe M, Say L, Gulmezoglu M, Khan KS (2006a) WHO systematic review of prevalence of chronic pelvic pain: a neglected reproductive health morbidity. BMC Public Health 6:177 Latthe P, Mignini L, Gray R, Hills R, Khan K (2006b) Factors predisposing women to chronic pelvic pain: systematic review. BMJ 332(7544):749–755 Lautenbacher S, Kundermann B, Krieg J-C (2006) Sleep deprivation and pain perception. Sleep Med Rev 10:357–369 Lee C, Crawford C, Hickey A (2014a) Mind-body therapies for the self-management of chronic pain syndromes. Pain Med 15:S21–S39 Lee C, Crawford C, Schoomaker E (2014b) Movement strategies for the self-management of chronic pain symptoms. Pain Med 15:S40–S53 Legros B, Bazil CW (2003) Effects of antiepileptic drugs on sleep architecture: a pilot study. Sleep Med 4(1):51–55 Leserman J, Zolnoun D, Meltzer-Brody S, Lamvu G, Steege JF (2006) Identification of diagnostic subtypes of chronic pelvic pain and how subtypes differ in health status and trauma history. Am J Obstet Gynecol 195(2):554–560, discussion 560–551 Li WY, Liabsuetrakul T, Stray-Pedersen B, Li YJ, Guo LJ, Qin WZ (2014) The effects of mode of delivery and time since birth on chronic pelvic pain and health-related quality of life. Int J Gynaecol Obstet 124(2):139–142 Loeser JD, Melzack R (1999) Pain: an overview. Lancet 353(9164):1607–1609 Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC (2006) Functional bowel disorders. Gastroenterology 130(5):1480–1491 Malykhina AP (2007) Neural mechanisms of pelvic organ cross-sensitization. Neuroscience 149(3):660–672 McLachlan EM, Janig W, Devor M, Michaelis M (1993) Peripheral nerve injury triggers noradrenergic sprouting within dorsal root ganglia. Nature 363(6429):543–546 Melnik T, Hawton K, McGuire H (2012) Interventions for vaginismus. Cochrane Database Syst Rev (12):CD001760 Milligan ED, Twining C, Chacur M, Biedenkapp J, O’Connor K, Poole S, Tracey K, Martin D, Maier SF, Watkins LR (2003) Spinal glia and proinflammatory cytokines mediate mirror-image neuropathic pain in rats. J Neurosci 23(3):1026–1040 Moore AR, Wiffen PJ, Derry S, Toelle T, Rice AS (2014) Gabapentin for chronic neuropathic pain and fibromyalgia in adults. Cochrane Database Syst Rev (4): CD007938 Morley S, Williams A, Eccleston C (2013) Examining the evidence about psychological treatments for chronic pain: time for a paradigm shift? Pain 154(10):1929–1931 Nelson P, Apte G, Justiz R, Brismee J-M, Dedrick G, Sizer PS (2011) Chronic female pelvic pain – part 2: differential diagnosis and management. Pain Pract 12:111–141 Nesbitt-Hawes EM, Won H, Jarvis SK, Lyons SD, Vancaillie TG, Abbott JA (2013) Improvement in pelvic pain with botulinum toxin type A – single vs. repeat injections. Toxicon 63(1):83–87 Nicholson T, Basile A (2006) Pelvic congestion syndrome, who should we treat and how? Tech Vasc Interv Radiol 9(1):19–23 Nikolajsen L, Sørensen H, Jensen T, Kehlet H (2004) Chronic pain following caesarean section. Acta Anaesthesiol Scand 48:111–116 Nnoaham KE, Kumbang J (2008) Transcutaneous electrical nerve stimulation (TENS) for chronic pain. Cochrane Database Syst Rev (3) Nunns D, Murphy R (2012) Assessment and management of vulval pain. BMJ (Online) 344(7850):38–42 Ong DK, Mitchell SB, Barrett JS, Shepherd SJ, Irving PM, Biesiekierski JR, Smith S, Gibson PR, Muir JG (2010) Manipulation of dietary short chain carbohydrates alters the pattern of gas production and genesis of symptoms in irritable bowel syndrome. J Gastroenterol Hepatol (Australia) 25(8):1366–1373 Parsons CL (2011) The role of a leaky epithelium and potassium in the generation of bladder symptoms in interstitial cystitis/overactive bladder, urethral syndrome, prostatitis and gynaecological chronic pelvic pain. BJU Int 107(3):370–375 Perry CP (2003) Peripheral neuropathies and pelvic pain: diagnosis and management. Clin Obstet Gynecol 46(4):789–796 Pezzone MA, Liang R, Fraser MO (2005) A model of neural cross-talk and irritation in the pelvis: implications for the overlap of chronic pelvic pain disorders. Gastroenterology 128(7):1953–1964 Phillips D, Deipolyi AR, Hesketh RL, Midia M, Oklu R (2014) Pelvic congestion syndrome: etiology of pain, diagnosis, and clinical management. J Vasc Interv Radiol 25(5):725–733 Pickersgill A (1998) GnRH agonists and add-back therapy: is there a perfect combination? Br J Obstet Gynaecol 105(5):475–485 Pilowsky I, Crettenden I, Townley M (1985) Sleep disturbance in pain clinic patients. Pain 23(1):27–33 Price J, Farmer G, Harris J, Hope T, Kennedy S, Mayou R (2006a) Attitudes of women with chronic pelvic pain to the gynaecological consultation: a qualitative study. BJOG 113(4):446–452 Price D, Zhou Q, Moshiree B, Robinson M, Verne G (2006b) Peripheral and central contributions to hyperalgesia in irritable bowel syndrome. J Pain 7:529–535 Pukall CF, Baron M, Amsel R, Khalife S, Binik YM (2006) Tender point examination in women with vulvar vestibulitis syndrome. Clin J Pain 22(7):601–609 Quinn M (2004) Endometriosis: the consequence of neurological dysfunction? Med Hypotheses 63(4):602–608 Quinn MJ, Kirk N (2002) Differences in uterine innervation at hysterectomy. Am J Obstet Gynecol 187(6):1515–1519, discussion 1519–1520 Rahman W, Bauer CS, Bannister K, Vonsy JL, Dolphin AC, Dickenson AH (2009) Descending serotonergic facilitation and the antinociceptive effects of pregabalin in a rat model of osteoarthritic pain. Mol Pain 5:45 Rogers R (2003) Pelvic denervation surgery: what the evidence and anatomy teach us. Clin Obstet Gynecol 46:767–772 Rosenberg MT, Page S, Hazzard MA (2007) Prevalence of interstitial cystitis in a primary care setting. Urology 69(4 Suppl):48–52 Saarto T, Wiffen PJ (2014) Antidepressants for neuropathic pain. Cochrane Database Syst Rev (1):CD005454 Sator-Katzenschlager SM, Scharbert G, Kress HG, Frickey N, Ellend A, Gleiss A, Kozek-Langenecker SA (2005) Chronic pelvic pain treated with gabapentin and amitriptyline: a randomized controlled pilot study. Wien Klin Wochenschr 117(21–22):761–768 Schultz WW, Basson R, Binik Y, Eschenbach D, Wesselmann U, Van Lankveld J (2005) Women’s sexual pain and its management. J Sex Med 2(3):301–316 Sedgwick P (2013a) What is number needed to harm (NNH)? BMJ (Online) 347(7920): f4869 Sedgwick P (2013b) What is number needed to treat (NNT)? BMJ (Online) 347(7918): f4605 Sengupta JN (2009) Visceral pain: the neurophysiological mechanism. Handb Exp Pharmacol 194:31–74 Shoja MM, Sharma A, Mirzayan N, Groat C, Watanabe K, Loukas M, Shane Tubbs R (2013) Neuroanatomy of the female abdominopelvic region: a review with application to pelvic pain syndromes. Clin Anat 26(1):66–76 Sindrup SH, Otto M, Finnerup NB, Jensen TS (2005) Antidepressants in the treatment of neuropathic pain. Basic Clin Pharmacol Toxicol 96(6):399–409 Smith MT, Edwards RR, McCann UD, Haythomthwaite JA (2007) The effects of sleep deprivation on pain inhibition and spontaneous pain in women. Sleep 30(4):494–505 Stanford EJ, Dell JR, Parsons CL (2007) The emerging presence of interstitial cystitis in gynecologic patients with chronic pelvic pain. Urology 69(4 Suppl):53–59 Staudacher HM, Irving PM, Lomer MCE, Whelan K (2014) Mechanisms and efficacy of dietary FODMAP restriction in IBS. Nat Rev Gastroenterol Hepatol 11(4):256–266 Stepanski EJ, Wyatt JK (2003) Use of sleep hygiene in the treatment of insomnia. Sleep Med Rev 7(3):215–225 Stones W, Cheong Y, Howard F (2005) Interventions for treating chronic pelvic pain in women. Cochrane Database Syst Rev (2):CD00038 Stones RW, Lawrence WT, Selfe SA (2006) Lasting impressions: influence of the initial hospital consultation for chronic pelvic pain on dimensions of patient satisfaction at follow-up. J Psychosom Res 60(2):163–167 Stratton P, Berkley KJ (2011) Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications. Hum Reprod Update 17(3):327–346 Swank DJ, Swank-Bordewijk SCG, Hop WCJ, Van Erp WFM, Janssen IMC, Bonjer HJ, Jeekel J (2003) Laparoscopic adhesiolysis in patients with chronic abdominal pain: a blinded randomised controlled multi-centre trial. Lancet 361(9365):1247–1251 Tan T, Barry P, Reken S, Baker M (2010) Pharmacological management of neuropathic pain in non-specialist settings: summary of NICE guidance. BMJ (Online) 340(7748):707 Teichman JMH, Parsons CL (2007) Contemporary clinical presentation of interstitial cystitis. Urology 69(4 Suppl):41–47 The Practice Committee of the American Society for Reproductive Medicine (2014) Treatment of pelvic pain associated with endometriosis: a committee opinion. Fertil Steril 101(4):927–935 Tokushige N, Markham R, Russell P, Fraser IS (2007) Different types of small nerve fibers in eutopic endometrium and myometrium in women with endometriosis. Fertil Steril 88(4):795–803 Treede RD, Jensen TS, Campbell JN, Cruccu G, Dostrovsky JO, Griffin JW, Hansson P, Hughes R, Nurmikko T, Serra J (2008) Neuropathic pain: redefinition and a grading system for clinical and research purposes. Neurology 70(18):1630–1635 Tu FF, Hellman KM, Backonja MM (2011) Gynecologic management of neuropathic pain. Am J Obstet Gynecol 205(5):435–443 Turk D, Okifuji A (2002) Psychological factors in chronic pain: evolution and revolution. J Consult Clin Psychol 70(3):678–690 Turunen JHO, Mäntyselkä PT, Kumpusalo EA, Ahonen RS (2004) How do people ease their pain? A population-based study. J Pain 5(9):498–504 Vercellini P, Fedele L, Pietropaolo G, Frontino G, Somigliana E, Crosignani PG (2003) Progestogens for endometriosis: forward to the past. Hum Reprod Update 9(4):387–396 Vercellini P, Fedele L, Aimi G, Pietropaolo G, Consonni D, Crosignani PG (2007) Association between endometriosis stage, lesion type, patient characteristics and severity of pelvic pain symptoms: a multivariate analysis of over 1000 patients. Hum Reprod 22(1):266–271 Vercellini P, Somigliana E, Viganò P, Abbiati A, Barbara G, Fedele L (2009) Chronic pelvic pain in women: etiology, pathogenesis and diagnostic approach. Gynecol Endocrinol 25(3):149–158 Vickers AJ, Linde K (2014) Acupuncture for chronic pain. JAMA 311(9):955–956 Vincent K, Warnaby C, Stagg CJ, Moore J, Kennedy S, Tracey I (2011) Dysmenorrhoea is associated with central changes in otherwise healthy women. Pain 152(9):1966–1975 Visser E, Schug SA (2006) The role of ketamine in pain management. Biomed Pharmacother 60(7):341–348 Watkins LR, Hutchinson MR, Rice KC, Maier SF (2009) The “toll” of opioid-induced glial activation: improving the clinical efficacy of opioids by targeting glia. Trends Pharmacol Sci 30(11):581–591 Weijenborg PT, Greeven A, Dekker FW, Peters AA, Ter Kuile MM (2007) Clinical course of chronic pelvic pain in women. Pain 132(Suppl 1):S117–S123 Weijenborg PTM, ter Kuile MM, Gopie JP, Spinhoven P (2009) Predictors of outcome in a cohort of women with chronic pelvic pain – a follow-up study. Eur J Pain 13(7):769–775 Wesselmann U (2001) Interstitial cystitis: a chronic visceral pain syndrome. Urology 57(6, Suppl 1):32–39 Wesselmann U, Burnett AL, Heinberg LJ (1997) The urogenital and rectal pain syndromes. Pain 73(3):269–294 Wiffen PJ, Derry S, Moore AR, Aldington D, Cole P, Rice AS, Lunn PTM, Hamunen K, Haanpaa M, Kalso EA (2013) Antiepileptic drugs for neuropathic pain and fibromyalgia – an overview of Cochrane reviews. Cochrane Database Syst Rev (12):CD010567 Williams DG, Patel A, Howard RF (2002) Pharmacogenetics of codeine metabolism in an urban population of children and its implications for analgesic reliability. Br J Anaesth 89(6):839–845 Williams R, Hartmann K, Sandler R, Miller W, Savitz L, Steege J (2005) Recognition and treatment of irritable bowel syndrome among women with chronic pelvic pain. Am J Obstet Gynecol 192:761–767 Woolf CJ (2011) Central sensitization: implications for the diagnosis and treatment of pain. Pain 152(Suppl 3):S2–S15 Woolf C, Mannion R (1999) Neuropathic pain: aetiology, symptoms, mechanisms, and management. Lancet 353:1959–1964 Woolf CJ, Salter MW (2000) Neuronal plasticity: increasing the gain in pain. Science 288(5472):1765–1768 Yunker A, Sathe NA, Reynolds WS, Likis FE, Andrews J (2012) Systematic review of therapies for noncyclic chronic pelvic pain in women. Obstet Gynecol Surv 67(7):417–425 Zondervan K, Yudkin P, Vessey M, Jenkinson C, Dawes M, Barlow D, Kennedy S (2001) The community prevalence of chronic pelvic pain in women and associated illness behaviour. Br J Gen Pract 51(468):541–547 Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations Rights and permissions Copyright information © 2015 Springer International Publishing Switzerland About this chapter Cite this chapter Gillett, W.R., Jones, D. (2015). Medical Treatment of Chronic Pelvic Pain. In: Harrison-Woolrych, M. (eds) Medicines For Women. Adis, Cham. https://doi.org/10.1007/978-3-319-12406-3_10 Download citation DOI: https://doi.org/10.1007/978-3-319-12406-3_10 Published: Publisher Name: Adis, Cham Print ISBN: 978-3-319-12405-6 Online ISBN: 978-3-319-12406-3 eBook Packages: MedicineMedicine (R0)

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