Women's Health

continued...

Counseling and mental skills training help you learn the mental and emotional tools for managing chronic pain and the stress that makes it worse. Commonly recommended approaches include:

• Cognitive-behavioral therapy focused on changing both the way you think about pain and your ability to mentally influence how pain affects you.
• Biofeedback, which is the conscious control of body function that is normally unconsciously controlled.
• Interpersonal counseling focused on best managing your life events, stressors, and relationships.

Alternative pain treatments such as acupuncture, transcutaneous nerve stimulation (TENS), hypnosis, guided imagery, aromatherapy, meditation, and yoga are low-risk pain treatments that many people use to manage pain. Acupuncture and TENS have shown some success in relieving painful menstrual periods. Acupuncture has also been used as a treatment for nonmenstrual chronic pelvic pain but has not been well studied.¹

Surgical treatment for chronic pelvic pain should be limited to the treatment of surgically correctable problems. Surgery is most useful for treatment of a specific cause of pelvic pain, such as fibroids or endometriosis.

Surgical removal of the reproductive organs may relieve chronic pelvic pain when the cause of pain cannot be found.¹ When surgery is done for pain with no known cause (hysterectomy or cutting of specific pelvic-area nerves), there is a risk of persistent or worsened pain after surgery as well as surgery-related side effects.

What To Think About

After 4 to 6 months of pain, some people develop chronic pain, which is a medical disorder that is separate from the original pain-causing condition. Because chronic pain and female pelvic pain have yet to be fully understood, treatment can be a trial-and-error process. It is common for women with chronic female pelvic pain to try many treatments before finding one or more that are helpful.

Decisions are complicated when considering treatment for chronic pelvic pain. Evaluate the following:

• Are the symptoms bothersome enough to require treatment?
• Do you want to have a child or more children?
• Has a specific cause of the pain been discovered, or is the cause unclear?
• Is menopause, which may stop symptoms, going to occur soon?
• Would an opinion from another doctor be helpful?
• Would an opinion from a doctor who specializes in chronic pain be valuable?
• Have you tried cognitive-behavioral therapy?