Noncyclic Chronic Pelvic Pain Therapies for Women
Background: Comorbidities Associated With Noncyclic CPP
Comorbidities frequently associated with CPP include IBS, with studies reporting IBS prevalence of 35 to 65 percent in women with CPP. As many as 85 percent of women with CPP meet some criteria for IC or PBS. Prevalence estimates for endometriosis in women with CPP range from 33 to 70 percent. Psychological comorbidities such as depression, anxiety, sleep disorders, hysteria, and alcohol abuse are also commonly reported among women with CPP. CPP has also been suggested to be associated with numerous general factors including abuse (childhood physical or sexual abuse, lifetime sexual abuse) and obstetric factors (previous miscarriage, cesarean birth).
However, understanding the prevalence of comorbidities and their contributions to overall pain is complex. Comorbidity research is complicated by the lack of standardized definitions or consistent diagnostic criteria for many conditions. Some research suggests that multiple comorbidities may intensify pain and dysfunction. Comorbidity research in CPP may also strive to define conditions that may be secondary end points, such as IBS, or to recognize conditions that may be important contributors to pain, such as depression.
- Andrews J, Yunker A, Reynolds WS, et al. Noncyclic Chronic Pelvic Pain Therapies for Women: Comparative Effectiveness. Comparative Effectiveness Review No. 41 (Prepared by the Vanderbilt Evidence-based Practice Center under Contract No. 290-2007-10065-I). Rockville, MD: Agency for Healthcare Research and Quality; January 2012. AHRQ Publication No. 11(12)-EHC088-EF. Available at www.effectivehealthcare.ahrq.gov/pelvicpain.cfm.
- Zondervan KT, Yudkin PL, Vessey MP, et al. Chronic pelvic pain in the community—symptoms, investigations, and diagnoses. Am J Obstet Gynecol 2001;184:1149-55. PMID: 11349181.
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