| Title | Chronic pelvic pain in women. | | Author(s) | Ortiz DD | | Institution | CHRISTUS Santa Rosa Family Medicine Residency Program, San Antonio, Texas 78207, USA. david.ortiz@christushealth.org | | Source | Am Fam Physician 2008 Jun 1; 77(11):1535-42. | | MeSH | Algorithms
Anti-Inflammatory Agents, Non-Steroidal
Chronic Disease
Contraceptives, Oral, Synthetic
Diagnosis, Differential
Female
Humans
Medroxyprogesterone
Pelvic Pain
Physical Examination
| | Abstract | The etiology of chronic pelvic pain in women is poorly understood. Although a specific diagnosis is not found in the majority of cases, some common diagnoses include endometriosis, adhesions, irritable bowel syndrome, and interstitial cystitis. The initial history and physical examination can narrow the diagnostic possibilities, guide any subsequent evaluation, and rule out malignancy or significant systemic disease. If the initial evaluation does not reveal a specific diagnosis, a limited laboratory and ultrasound evaluation can clarify the diagnosis, as well as rule out serious disease and reassure the patient. Few treatment modalities have demonstrated benefit for the symptoms of chronic pelvic pain. The evidence supports the use of oral medroxyprogesterone, goserelin, adhesiolysis for severe adhesions, and a multidisciplinary treatment approach for patients without a specific diagnosis. Less supporting evidence is available for oral analgesics, combined oral contraceptive pills, gonadotropin-releasing hormone agonists, intramuscular medroxyprogesterone, trigger point and botulinum A toxin injections, neuromodulative therapies, and hysterectomy. | | Language | eng | | Pub Type(s) | Journal Article
Review
| | PubMed ID | 18581833 |
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