Women were asked to indicate on a diagram the areas where they felt pain. The color-coded blocks show the number of women reporting pain, ranging from the least pain (top block) to the most pain (bottom block). Most women reported pain in the pelvic-abdominal area. The greatest number of women reporting pain in the pelvic-abdominal area were those later diagnosed with endometriosis. Credit: Human Reproduction
“Our study suggests that many reproductive-age women are experiencing but not reporting some form of pelvic pain,” Dr. Schliep said. “If they aren’t doing so already, gynecologists may want to ask their patients if they’re experiencing pain, as well as the type and precise location of the pain, and offer treatment as appropriate. Similarly, women should let their doctors know if they’re in pain.”
The researchers enrolled 473 women ages 18 to 44 years at 14 surgical centers in Salt Lake City and San Francisco. The women were set to undergo eitherlaparoscopy, a surgical procedure which involves inserting a camera at the end of a tube through a tiny incision in the abdomen, or a laparotomy, which involves making a larger incision in the pelvic region. The women were seeking care or treatment for pain, for a mass or lump in the pelvic region, infertility, menstrual irregularities, or for tubal sterilization.
In an interview before their surgery, the women were asked about the kind of pain they had experienced in the past six months, along with its severity. In all, the women were asked if they had more than 17 specific types of pain related to sexual intercourse, their menstrual period, urination or bowel elimination, or other pain, such as muscle or joint pain or migraine headaches. In addition, they were asked to indicate on diagrams of the pelvic area and of a standing female figure where they felt pain.
More than 30 percent of the women reported that they were experiencing chronic pain and cyclic pain—coinciding with an interval during their monthly menstrual cycle—lasting six months or more. This 30 percent included not only women with pelvic disorders, but also those without any pelvic condition. In addition, regardless of the reason they had surgery or of their diagnosis after the operation, only 3 percent of the total study population reported having none of the 17 types of pain, while over 60 percent reported six or more types of pain.
Among the study participants, approximately 40 percent were diagnosed with endometriosis, and 31 percent with other conditions, including uterine fibroids, ovarian cysts, and tumors. Nearly 29 percent had not been diagnosed with any pelvic conditions.
Women diagnosed with endometriosis experienced the most chronic pain, at slightly more than 44 percent, compared to about 30 percent of women without any pelvic condition. Similarly, women with endometriosis were more likely to experience pain during intercourse, menstrual cramping and pain with bowel elimination. They also were more likely to report vaginal pain and pain in the pelvic-abdominal area.
The study authors called for future research on the type and location of pain associated with endometriosis. Results of such studies might lead to better diagnosis and treatment of the disorder. The authors also called for additional research on the causes of pain in women not diagnosed with any pelvic condition.
About the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD): The NICHD sponsors research on development, before and after birth; maternal, child, and family health; reproductive biology and population issues; and medical rehabilitation. For more information, visit the Institute’s website athttp://www.nichd.nih.gov.
Understanding Pelvic Pain [CHART] was originally published on blackdoctor.org
