Pelvic pain is not only a medical problem, but also a psychosocial problem. Women with chronic pelvic pain often have increased rates of stress, anxiety, and depression, as well as difficulty forming personal relationships. Partners of such women often experience emotional distress, isolation and a sense of powerlessness in trying to establish normal relationships.
Find out in the article on estet-portal.com under which pathologies the chronic pelvic pain syndrome most often develops.
- Endometriosis as a common cause of chronic pelvic pain
- Cystitis and myofascial syndrome in chronic pelvic pain
- Venous congestion in chronic pelvic pain
Endometriosis as a common cause of chronic pelvic pain
Endometriosis is the most common gynecological cause of CPP, characterized by significant fluctuations in pain during the menstrual cycle.
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Therefore, women with cyclic chronic pelvic pain syndrome may benefit from empiric hormone therapy for at least 3-6 months prior to exploratory laparoscopy (Royal College of Obstetricians and Gynecologists).
Chronic cystitis: etiology and clinical picture
Oral contraceptives, gonadotropin-releasing hormone (GHG) analogues, progestogens and danazol have proven efficacy, however, their safety profiles differ significantly. Thus, in one comparative study, women who received HGH analogues had a greater reduction in pain scores compared to those who took oral contraceptives, but they experienced a significant decrease in bone mineral density.
This adverse effect of HGH analogues can be mitigated by the addition of low doses of norethindrone, estrogen, or a combination of estrogen and progesterone, which simultaneously reduces hot flashes and
Intermediate cystitis accompanies endometriosis and CPP in 60% of patients. Under these conditions, pentosan polysulfate sodium is indicated as initial therapy, the oral use of which in interstitial cystitis
approved by the Food and Drug AdministrationUSA (Food and Drug Administration, FDA). This drug restores the protective layer of glycosaminoglycans in the bladder. Amitriptyline is also recommended for the treatment of nocturia associated with interstitial cystitis.
Pharmacotherapy of chronic renal failure A recent systematic review of the treatment of chronic pelvic pain demonstrated the efficacy of neuromuscular blockade in patients with symptoms of myofascial pain.
Reported lower pain scores 6 months after botulinum toxin treatment in women with chronic pelvic pain due to pelvic floor spasm compared to womenwho were injected with placebo.
Venous congestion in chronic pelvic pain Pelvic venous stasis syndrome can be treated with hormonal, radiological, or surgical therapy. In study participants with pain due to pelvic congestion, the use of medroxyprogesterone acetate or the GHRH agonist goserelin,
which significantly improved pelvic symptoms.
found that medroxyprogesterone acetate predominantly resulted in a 50% reduction in pain with a duration of action of the drug up to 9 months compared with patients who who were taking a placebo. In comparative studies,
HRH analogues were more effective in reducing chronic pelvic pain thanprogestogens. X-ray therapy is as effective in eliminating CPP as hysterectomy and even has an advantage, since this procedure can be performed on an outpatient basis. Diagnosis, treatment and prevention of urolithiasis from the standpoint of evidence-based medicine
Irritable Bowel Syndrome ─ most likely cause if chronic pelvic pain is associated with changes in stool consistency or frequency of defecation. These patients are often prescribed antispasmodics, but their anticholinergic effects may exacerbate constipation. Diet therapy and dietary fiber supplementation improve symptoms.
Physical therapy aims to restore strength, elasticity, balance and coordination of the pelvic floor muscles and surrounding lumbopelvic muscles, which improves bowel, bladder and genital function. Especially indicated in patients with dyspareunia, vaginismus, or pinpoint tenderness on examination.
This type of treatment is performed by a physical therapist using specific pelvic floor muscle training techniques. Male hormonal contraception: key features
The purpose of relaxation exercises is to reduce the tone of overactive pelvic muscles, which improves the symptoms of chronic pelvic pain, vulvodynia, and perineal neuralgia. The patient is told what exactly causes excessive tone of the pelvic floor muscles, and is offered a set of exercises that reduce muscle tone.
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