Pharmacological Treatment of Chronic Pelvic Pain
This review chapter examines various treatments for chronic pelvic pain, which stems from somatic and visceral pathologies causing pain neuraxis sensitization, and assesses their efficacy.
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This chapter reviews pharmacological approaches to chronic pelvic pain, a symptom complex affecting both sexes, describing treatment strategies aimed at different components of the pain neuraxis and linking chronicity to peripheral and central sensitization. It summarizes evidence for several medication classes used across chronic pelvic pain syndromes, including anti-inflammatory analgesics, selective COX-2 inhibitors, combinations such as paracetamol plus caffeine, antidepressants and anticonvulsants (e.g., gabapentin/pregabalin), and also discusses procedures or localized pharmacologic approaches that are often discussed alongside systemic therapies. A key caveat is that chronic pelvic pain encompasses multiple underlying pathologies and targets, so efficacy is presented as across-syndrome evidence rather than as a single unified mechanism. Relevance to endometriosis: the chapter includes and cites multiple sources specifically on endometriosis medical management and pain (e.g., reviews and trials of hormonal therapies and related pharmacologic options), though the paper’s main focus is a broad pharmacological review of chronic pelvic pain rather than endometriosis alone.
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