Factors predisposing women to chronic pelvic pain: systematic review

Abstract

Objective To evaluate factors predisposing women to chronic and recurrent pelvic pain. Design, data sources, and methods Systematic review of relevant studies without language restrictions identified through Medline, Embase, PsycINFO, Cochrane Library. SCISEARCH, conference papers, and bibliographies of retrieved primary and review articles. Two reviewers independently extracted data on study characteristics, quality, and results. Exposure to risk factors was compared between women with and without pelvic pain. Results were pooled within subgroups defined by type of pain and risk factors. Results There were 122 studies (in 111 articles) of which 63 (in 64 286 women) evaluated 54 risk factors for dysmenorrhoea, 19 (in 18 601 women) evaluated 14 risk factors for dyspareunia, and 40 (in 12 040 women) evaluated 48 factors for non-cyclical pelvic pain. Age < 30 years, low body mass index, smoking, earlier menarche ( < 12 years), longer cycles, heavy menstrual flow, nulliparity, premenstrual syndrome, sterilisation, clinically suspected pelvic inflammatory disease, sexual abuse, and psychological symptoms were associated with dysmenorrhoea. Younger age at first childbirth, exercise, and oral contraceptives were negatively associated with dysmenorrhoea. Menopause, pelvic inflammatory disease, sexual abuse, anxiety, and depression were associated with dyspareunia. Drug or alcohol abuse, miscarriage, heavy menstrual flow, pelvic inflammatory disease, previous caesarean section, pelvic pathology, abuse, and psychological comorbidity were associated with an increased risk of non-cyclical pelvic pain. Conclusion Several gynaecological and psychosocial factors are strongly associated with chronic pelvic pain. Randomised controlled trials of interventions targeting these potentially modifiable factors are needed to assess their clinical relevance in chronic pelvic pain.

Meaningfulness of Apitherapeutic Approaches Using the Example of Primary Dysmenorrhoea

“…Unsuitable, demonstrably ineffective or harmful methods: magnetic therapy, osteopathy, manual therapy, avoidance of coffee, cola and/or alcohol, homoeopathy, and relaxation therapy [80][81][82][83][84][85]. Possibly useful methods: traditional Chinese herbal medicine, acupuncture and acupressure, moxibustion, omega-3 fatty acids, vitamin B1, vitamin E, magnesium, exercise, yoga, chaste tree, yarrow, toki-shakuyaku-san -Kampo medicine from Japan, cinnamon [81,[86][87][88][89][90][91][92][93][94][95].…”

Impact of male partner responses on sexual function in women with vulvodynia and their partners: A dyadic daily experience study.

“…Because the primary interference of vulvodynia is with sexual activity, the woman and partner each confront the problem independently, but they also face it together as an interdependent dyadic unit (Latthe, Mignini, gray, Hills, & Khan, 2006). It is therefore important to obtain separate reports from both partners, in order to isolate the effects of male partner responses perceived by the woman from those perceived by the male partner himself.…”

The role of exercise in the treatment of menstrual disorders: the evidence

“…However, a recent systematic review located only one published randomised controlled trial and this was published two decades ago. 12 In this trial those randomised to exercise reported significantly lower dysmenorrhoea symptomatology than non-exercising controls, but the sample size was very small (n = 36) with only 26/36 participants completing follow-up. Several additional non-randomised intervention studies were located by the review 13 but these were also of very poor methodological quality, the most recent of which was published over 40 years ago.…”