Noncyclic Chronic Pelvic Pain Therapies for Women
Background: Etiology of Noncyclic CPP
The pathophysiology of chronic pelvic pain is complex and is not well understood. Noncyclic CPP frequently has more than one underlying cause. Potential causes for noncyclic CPP that have been identified include:
- Gynecological causes such as endometriosis, pelvic inflammatory disease, adhesions and pelvic floor muscle spasm
- Gastrointestinal causes such as irritable bowel syndrome or IBS, celiac disease and inflammatory bowel disease
- Urologic causes such as interstitial cystitis or painful bladder syndrome and chronic urinary tract infection
- Musculoskeletal causes such as myofascial pain disorders, fibromyalgia and degenerative disk disease
- Psychiatric/neurologic causes such as depression, neurologic dysfunction, abdominal epilepsy and sleep disturbance
The four most commonly diagnosed etiologies for noncyclic CPP are endometriosis, adhesions, IBS, and IC.
The multifactorial etiology of noncyclic CPP complicates diagnosis, and a definitive diagnosis is not made for 61 percent of women with CPP.
- 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.
- Ortiz DD. Chronic pelvic pain in women. Am Fam Physician 2008;77:1535-42. PMID: 18581833.
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