Chronic pelvic pain in women

David D Ortiz, David Ortiz
American family physician · 2008 · vol. 77(11) , pp. 1535–42 · PMID:18581833 · W52947674
Review OA: closed CC0 ⤵ 22 in-corpus citations
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This review outlines the diagnostic workup and limited evidence-based treatments for chronic pelvic pain in women, which often lacks a specific diagnosis but may include conditions like endometriosis or IBS.

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Abstract

The etiology of chronic pelvic pain in women is poorly understood. Although a specific diagnosis is not found in the majority of cases, some common diagnoses include endometriosis, adhesions, irritable bowel syndrome, and interstitial cystitis. The initial history and physical examination can narrow the diagnostic possibilities, guide any subsequent evaluation, and rule out malignancy or significant systemic disease. If the initial evaluation does not reveal a specific diagnosis, a limited laboratory and ultrasound evaluation can clarify the diagnosis, as well as rule out serious disease and reassure the patient. Few treatment modalities have demonstrated benefit for the symptoms of chronic pelvic pain. The evidence supports the use of oral medroxyprogesterone, goserelin, adhesiolysis for severe adhesions, and a multidisciplinary treatment approach for patients without a specific diagnosis. Less supporting evidence is available for oral analgesics, combined oral contraceptive pills, gonadotropin-releasing hormone agonists, intramuscular medroxyprogesterone, trigger point and botulinum A toxin injections, neuromodulative therapies, and hysterectomy.

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Condition tags

chronic_pelvic_painendometriosisinterstitial_cystitisirritable_bowel_syndrome

MeSH descriptors

Pelvic Pain Pelvic Pain Pelvic Pain Pelvic Pain Pelvic Pain Physical Examination Algorithms Algorithms Anti-Inflammatory Agents, Non-Steroidal Anti-Inflammatory Agents, Non-Steroidal Anti-Inflammatory Agents, Non-Steroidal Chronic Disease Chronic Disease Contraceptives, Oral, Synthetic Contraceptives, Oral, Synthetic Contraceptives, Oral, Synthetic Contraceptives, Oral, Synthetic Diagnosis, Differential Diagnosis, Differential Female

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Cited by (22)

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