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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.

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  • Authors+Show Affiliations

    ,

    Academic Department of Obstetrics and Gynaecology, University of Birmingham, Birmingham B15 2TG. pallavi@doctors.org.uk

    , , ,

    Source

    BMJ (Clinical research ed.) 332:7544 2006 Apr 01 pg 749-55

    MeSH

    Chronic Disease
    Dysmenorrhea
    Dyspareunia
    Female
    Humans
    Pelvic Pain
    Regression Analysis
    Risk Factors

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Research Support, Non-U.S. Gov't
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    16484239

    Citation

    Latthe, Pallavi, et al. "Factors Predisposing Women to Chronic Pelvic Pain: Systematic Review." BMJ (Clinical Research Ed.), vol. 332, no. 7544, 2006, pp. 749-55.
    Latthe P, Mignini L, Gray R, et al. Factors predisposing women to chronic pelvic pain: systematic review. BMJ. 2006;332(7544):749-55.
    Latthe, P., Mignini, L., Gray, R., Hills, R., & Khan, K. (2006). Factors predisposing women to chronic pelvic pain: systematic review. BMJ (Clinical Research Ed.), 332(7544), pp. 749-55.
    Latthe P, et al. Factors Predisposing Women to Chronic Pelvic Pain: Systematic Review. BMJ. 2006 Apr 1;332(7544):749-55. PubMed PMID: 16484239.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Factors predisposing women to chronic pelvic pain: systematic review. AU - Latthe,Pallavi, AU - Mignini,Luciano, AU - Gray,Richard, AU - Hills,Robert, AU - Khan,Khalid, Y1 - 2006/02/16/ PY - 2006/2/18/pubmed PY - 2006/4/11/medline PY - 2006/2/18/entrez SP - 749 EP - 55 JF - BMJ (Clinical research ed.) JO - BMJ VL - 332 IS - 7544 N2 - 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. SN - 1756-1833 UR - https://www.unboundmedicine.com/medline/citation/16484239/full_citation L2 - http://www.bmj.com/cgi/pmidlookup?view=long&amp;pmid=16484239 DB - PRIME DP - Unbound Medicine ER -