What is a reasonable approach to management of women with pelvic pain?
Pelvic pain in women is as common as the common cold, it seems. Certainly that is the impression one is left with after reading the article by Pitts et al on the prevalence and correlates of pelvic pain in Australian women. Pitts and colleagues found that 72% of women experienced dysmenorrhoea and only one in four women did not report any kind of pelvic pain.1 A systematic review of international studies reported a similar prevalence of dysmenorrhoea and pelvic pain.2
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- Department of Obstetrics and Gynaecology and National Women’s Health, University of Auckland, Auckland, New Zealand.
- 1. Pitts MK, Ferris JA, Smith AMA, et al. Prevalence and correlates of three types of pelvic pain in a nationally representative sample of Australian women. Med J Aust 2008; 189: 138-143.
- 2. Latthe P, Latthe M, Say L, et al. WHO systematic review of prevalence of chronic pelvic pain: a neglected reproductive health morbidity. BMC Public Health 2006; 6: 177.
- 3. Fauconnier A, Chapron C. Endometriosis and pelvic pain: epidemiological evidence of the relationship and implications. Hum Reprod Update 2005; 11: 595-606.
- 4. Royal College of Obstetrics and Gynaecology. Pain in obstetrics and gynaecology — study group statement. http://www.rcog.org.uk/index.asp?PageID=1739 (accessed Jun 2008).
- 5. Gambone JC, Mittman BS, Munro MG, et al. Consensus statement for the management of chronic pelvic pain and endometriosis: proceedings of an expert-panel consensus process. Fertil Steril 2002; 78: 961-972.
- 6. American College of Obstetricians and Gynecologists. ACOG committee opinion. No. 310, April 2005. Endometriosis in adolescents. Obstet Gynecol 2005; 105: 921-927.
- 7. Kennedy S. Should a diagnosis of endometriosis be sought in all symptomatic women? Fertil Steril 2006; 86: 1312-1313.
- 8. Garry R. Diagnosis of endometriosis and pelvic pain. Fertil Steril 2006; 86: 1307-1309.
- 9. Hadfield R, Mardon H, Barlow D, Kennedy S. Delay in the diagnosis of endometriosis: a survey of women from the USA and the UK. Hum Reprod 1996; 11: 878-880.
- 10. Ballard KD, Lowton K, Wright JT. What’s the delay? A qualitative study of women’s experiences of reaching a diagnosis of endometriosis. Fertil Steril 2006; 86; 1296-1301.
- 11. Marjoribanks J, Proctor ML, Farquhar C. Nonsteroidal anti-inflammatory drugs for primary dysmenorrhoea. Cochrane Database Syst Rev 2003; (4): CD001751.
- 12. Chooi CL, Clarke J, Farquhar CM, Roberts H. Combined oral contraceptive pill (OCP) as treatment for primary dysmenorrhoea. Cochrane Database Syst Rev 2008; (3). In press.