Chronic Pelvic Pain

In: Pain in Children · 2008 · pp. 209–217 · doi:10.1007/978-1-59745-476-6_21 · W1535741099
book-chapter OA: closed CC0
Full text JSON View on OpenAlex View at publisher
AI-generated summary by claude@2026-06, 2026-06-13

Adolescent pelvic pain, often stemming from gynecologic, gastrointestinal, urologic, or musculoskeletal issues, is treated with targeted therapies, medications, and multidisciplinary approaches.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

AI-generated deep summary by claude@2026-06, 2026-06-13 · read from full text

This chapter reviews chronic pelvic pain in adolescents, describing the broad differential diagnosis (including gynecologic, gastrointestinal, urologic, and musculoskeletal mimics) and the high-level approach to evaluation and initial management. It notes that dysmenorrhea and endometriosis are common gynecologic causes, while persistent pain may be managed through multidisciplinary care that can include medication trials, cognitive-behavioral therapy, physical therapy, and complementary and alternative therapies. A key limitation is that the text is a narrative overview rather than a single study, so it does not provide new original data or uniform evidence grading across interventions. Relevance to endometriosis: the chapter specifically identifies endometriosis as a frequent gynecologic cause of adolescent pelvic pain and summarizes related diagnostic/treatment perspectives, though its main focus is a general framework for chronic pelvic pain management.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Abstract

Pelvic pain is a common but clinically challenging problem seen among adolescents. Dysmenorrhea and endometriosis are frequent gynecologic causes of pelvic pain; however, gastrointestinal, urologic, and musculokeletal conditions can mimic pain of gynecologic origin. Initial therapy is aimed at treating the underlying condition. Nonsteroidal medications, antidepres-sants and anticonvulsants are sometimes used in the treatment of pelvic pain. Patients who continue to experience pain may benefi t from a multidiscipli-nary treatment approach consisting of medication trials, cognitive-behavioral therapy, physical therapy, and complementary and alternative therapies.
Full text 9,544 characters · extracted from oa-doi-fallback · 2 sections · click to expand

Abstract

Pelvic pain is a common but clinically challenging problem seen among adolescents. Dysmenorrhea and endometriosis are frequent gynecologic causes of pelvic pain; however, gastrointestinal, urologic, and musculokeletal conditions can mimic pain of gynecologic origin. Initial therapy is aimed at treating the underlying condition. Nonsteroidal medications, antidepres-sants and anticonvulsants are sometimes used in the treatment of pelvic pain. Patients who continue to experience pain may benefi t from a multidiscipli-nary treatment approach consisting of medication trials, cognitive-behavioral therapy, physical therapy, and complementary and alternative therapies. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

References

Klein JR, Litt IF. Epidemiology of adolescent dys-menorrhea. Pediatrics 1981;68:661–664. Howard FM. The role of laparoscopy in chronic pelvic pain: promise and pitfalls. Obstet Gynecol 1993;48:357–387. Jamieson DJ, Steege JF. The prevalence of dysmen-orrhea, dyspareunia, pelvic pain, and irritable bowel syndrome in primary care practices. Obstet Gynecol 1996 87:55–58. Laufer MR, Sanfilippo J, Rose G. Adolescent endometriosis: diagnosis and treatment approaches. J Pediatr Adolesc Gynecol. 2003 16:S3–11. Breech LL, Laufer MR. Obstructive anomalies of the female reproductive tract. J Reprod Med 1999;44: 233–240. Andersch B, Milson I. An epidemiologic study of young women with dysmenorrhea. Am J Obstet Gynecol. 1982;144:655–660. Harlow SD, Park M. A longitudinal study of risk factors for the occurrence, duration, and severity of menstrual cramps in a cohort of college women. Br J Obstet Gynecol 1996;103:1134–1142. Schroeder B, Sanfilippo JS. Dysmenorrhea and pelvic pain in adolescents. Pediatr Clin North Am 1999;46:555–571. Marjoribanks J, Proctor ML, Farquhar C. Nonsteroidal anti-inflammatory drugs for primary dysmenorrhoea. Cochrane Database Syst Rev. 2003;4:CD001751. Mehlisch DR. Ketoprofen, ibuprofen, and placebo in the treatment of primary dysmenorrheal: a double-blind crossover comparison. J Clin Pharmacol 1988;28:S29–33. Mehlisch DR. Double-blind crossover comparison of ketoprofen, naproxen, and placebo in patients with primary dysmenorrheal. Clin Ther 1990;12:398–409. Marchini M, Tozzi L, et al. Comparative efficacy of diclofenac dispersible 50 mg and ibuprofen 400 mg in patients with primary dysmenorrhea, a randomized, double-blind within-patient, placebo-controlled study. Int J Clin Pharmacol Ther 1995;33:491–497. Larsson G, Milsom I, Lindstedt G, et al. The influence of a low-dose combined oral contraceptive on menstrual blood loss and iron status. Contraception 1992;46:327–334. Milsom I, Andersch B. Effect of various oral contraceptive combinations on dysmenorrhea. Gynecol Obstet Invest 1984;16:284–292. Vercellini P, Fedele L, Arcaini L, Rognoni MT, Candiani GB. Value of intrauterine device insertion and estrogen administration after hysteroscopic metroplasty. J Reprod Med. 1989;34:447–450. Kontoravdis A, Hassan E, Hassiakos D, et al. Laparoscopic evaluation and management of chronic pelvic pain during adolescence. Clin Exp Obstet Gynecol 1999;26:76–77. Laufer MR, Goitein L, Bush M, Cramer DW, Emans SJ. Prevalence of endometriosis in adolescent girls with chronic pelvic pain not responding to conventional therapy. J Pediatr Adolesc Gynecol. 1997;10:199–202. Fedele L, Parazzini F, Bianchi S, et al. Stage and localization of pelvic endometriosis and pain. Fertil Steril 1990;53:155–158. Parazzini F, Fedele L, Busacca M, et al. Postsurgical medical treatment of advanced endometriosis: results of a randomized clinical trial. Am J Obstet Gynecol 1994;171:1205–1207. Hornstein MD, Hemmings R, Yuzpe AA, Heinrichs WL. Use of nafarelin versus placebo after reductive laparoscopic surgery for endometriosis. Fertil Steril 1997;68:860–864. Vercellini P, Crosignani PG, Fadini R, et al. A gonadotro-pin-releasing hormone agonist compared with expectant management after conservative therapy for endometriosis. Br J Obstet Gynecol 1999;106:672–677. Gambone JC, Mittman BS, Munro MG, et al. Consensus statement for the management of chronic pelvic pain and endometriosis: Proceedings of an expert-panel consensus process. Fertil Steril 2002;78:961–972. Williams RE, Hartmann KE, Sandler RS, et al. Prevalence and characteristics of irritable bowel syndrome among women with chronic pelvic pain. Obstet Gynecol 2004;104:452–458. Talley NJ. Functional gastrointestinal disorders in 2007 and Rome III: Something new, something borrowed, something objective. Rev Gastroenterol Disord 2007;7:97–105. Van Ginkel R, Voskuijl WP, Benninga MA, Taminiau JA, Boeckxstaens GE. Alterations in rectal sensitivity and motility in childhood irritable bowel syndrome. Gastroenterology. 2001;120:31–38. Lydiard RB. Irritable bowel syndrome, anxiety, and depression: what are the links? J Clin Psychiatry 2001;62:38–45. Kline RM, Kline JJ, Di Palma J, Barbero GJ. Enteric-coated, pH-dependent peppermint oil capsules for the treatment of irritable bowel syndrome in children. J Pediatr 2001;138:125–128. Schroeder B, Sanfilippo JS, Hertweck Sp. Musculoskeletal pelvic pain in a pediatric and adolescent gynecology practice. J Pedatr Adolesc Gynecol 2000;13:90. Tu FF, As-Sanie S, Steege JF. Prevalence of pelvic musculoskeletal disorders in a female chronic pelvic pain clinic. J Reprod Med. 2006;51:185–189. Driscoll AM, Teichman JMH. How do patients with interstitial cystitis present? J Urol 2001;166:2118– 2120. Parsons CL, Tatsis V. Prevalence of interstitial cystitis in young women. Urology 2004;64:866–870. Parsons CL, Dell J, Stanford EJ, et al. Increased prevalence of interstitial cystitis: previously unrecognized urologic and gynecologic cases identified using a new symptom questionnaire and intravesical potassium sensitivity. Urology 2002;60:573–578. Parsons CL. Interstitial cystitis: clinical manifestations and diagnostic criteria in over 200 cases. Neurourol Urodyn 1990;9:241–250. Eickson DR, Morgan KC, Ordille S, et al. Nonbladder related symptoms in patients with interstitial cystitis. J Urol 2001;166:557–561. Clemons JL, Arya LA, Myers DL. Diagnosing interstitial cystitis in women with chronic pelvic pain. Obstet Gynecol 2002;100:337–341. Stanford EJ, Koziol J, Feng A. The prevalence of interstitial cystitis, endometriosis, adhesions, and vulvar pain in women with chronic pelvic pain. J Minim Invasive Gynecol 2005;12:43–49. Chung MK, Chung RR, Gordon D, et al. The evil twins of chronic pelvic pain syndrome: Endometriosis and interstitial cystitis. JSLS 2002;6:311–314. Parsons CL. Advances in the treatment of interstitial cystitis. Expert Opin Pharmacother 2006;7:411–419. Weiss JM. Pelvic floor myofascial trigger points: manual therapy for interstitial cystitis and the urgency-frequency syndrome. J Urol 2001;166:2226–2231. Greco CD. Management of adolescent chronic pelvic pain from endometriosis: a pain center perspective. J Pediatr Adolesc Gynecol 2003;16:S17–19. Peters AA. A randomized clinical trial to compare two different approaches in women with chronic pelvic pain. Obstet Gynecol 1991;77:740–741. Max MB, Culnane M, Schafer SC, et al. Amitriptyline relieves diabetic neuropathy pain in patients with normal or depressed mood. Neurology 1987;37:589–596. Bowsher D. The effects of pre-emptive treatment of postherpetic neuralgia with amitriptyline: A randomized, double-blind, placebo-controlled trial. J Pain Symptom Manage 1997;13:327–331. Berde CB, LeBel AA, Olsson G. Neuropathic pain in children. In: Schechter NL, Berde CB, Yaster M, editors. Pain in Infants, Children, and Adolescents. Philadelphia: Lippincott, Williams & Wilkins, 2003. Sinrup SH. Pharmacologic treatment of pain in polyneuropathy. Neurology 2000;55:915–920. Eller LS. Guided imagery interventions for symptom management. Annu Rev Nurs Res 1999;17:57–84. Rusy LM. Complementary therapies for acute pediatric management. Pediatr Clin North Am 2000;47:589–599. Hawkins RS, Hart AD. The use of thermal biofeed-back in the treatment of pain associated with endome-triosis: Preliminary findings. Appl Psychophysiol Biofeedback 2003;28:279–289. Kotarinos RK. Pelvic floor physical therapy in uro-gynecologic disorders. Curr Women's Health Rep. 2003;3:334–339. McQuay HJ, Moore RA, Eccleston C, et al. Systematic review of outpatient services for chronic pain control. Health Technol Assess 1997;1:1–135. Swisher EM, Cohn DE, Goff BA, et al. Use of complementary and alternative medicine among women with gynecologic cancers. Gynecol Oncol 2002;84:363–367. Smith CA, Collins CT, Cyna AM, et al. Complementary and alternative therapies for pain management in labor. Cochrane Database Syst Rev 2006;18:CD003521. Kemper KJ, Sarah R, Silver-Highfield E, et al. On pins and needles? Pediatric pain patients' experience with acupuncture. Pediatrics 2000;105:941–947. Author information Authors and Affiliations Editor information Editors and Affiliations Rights and permissions Copyright information © 2008 Humana Press, a part of Springer Science+Business Media, LLC About this chapter Cite this chapter Greco, C.D. (2008). Chronic Pelvic Pain. In: Walco, G.A., Goldschneider, K.R., Berde, C.B. (eds) Pain in Children. Humana Press. https://doi.org/10.1007/978-1-59745-476-6_21 Download citation DOI: https://doi.org/10.1007/978-1-59745-476-6_21 Publisher Name: Humana Press Print ISBN: 978-1-934115-31-2 Online ISBN: 978-1-59745-476-6 eBook Packages: MedicineMedicine (R0)

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

Ask this paper AI returns verbatim quotes from the full text · source: oa-doi-fallback

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Condition tags

endometriosischronic_pelvic_paindysmenorrhea

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (54)

Source provenance

openalex
last seen: 2026-06-04T00:00:01.174412+00:00
License: CC0 · commercial use OK