Efficacy of non-pharmacological therapies in chronic pelvic pain of endometriosis: a systematic review and meta-analysis

Hegila da Silva Dantas, Dantas HDS, Hégila da Silva Dantas, Maiara Costa de Oliveira, de Oliveira MC, Maiara Oliveira, Tatiana Camila de Lima Alves da Silva, da Silva TC, Tatiana Cla da Silva, Joyce Mp de Oliveira, de Oliveira JM, Joyce Maria Pereira de Oliveira, Maria Letícia A. S. de Carvalho, Maria Las de Carvalho, de Carvalho ML, Micussi MT, Maria Thereza Albuquerque Barbosa Cabral Micussi, Maria Tabc Micussi
Journal of gynecology obstetrics and human reproduction · 2025 · vol. 54(9) , pp. 103006 · doi:10.1016/j.jogoh.2025.103006 · PMID:40774414 · W4412999295
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This systematic review and meta-analysis evaluated the efficacy of non-pharmacological therapies for managing chronic pelvic pain associated with endometriosis.

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Abstract

INTRODUCTION: Endometriosis is a condition that manifests through chronic pelvic pain and infertility. Current therapeutic options do not provide complete relief and may result in undesirable side effects. OBJECTIVE: To evaluate the efficacy of non-pharmacological therapies in relieving chronic pelvic pain compared to placebo therapies in women with endometriosis. METHODS: Developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and registered in Prospero (CRD42023455704). The searches were conducted in the Web of Science, PubMed, Scielo, Embase, and Pedro databases. We included clinical trials that employed non-pharmacological therapies and evaluated chronic pelvic pain as the primary outcome. The risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to evaluate the quality of the evidence. RESULTS: Nine studies were included. All studies addressed pain. The intervention group showed greater efficacy in reducing pain compared to the control group, except in one study. Five studies presented a high risk of bias, while four showed a low risk of bias. The meta-analysis for the pain outcome was conducted with five articles. The intervention was superior to the control, effectively reducing pain, with a mean difference of -1.40; 95 % CI -1.71, -1.09. CONCLUSION: The studies showed improvements in pain relief and quality of through non-pharmacological therapies. However, evidence confidence was very low. This highlights the need for more rigorous studies to confirm the efficacy of non-pharmacological interventions in reducing pain in endometriosis.

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endometriosischronic_pelvic_pain

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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.

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