The Impact of Chronic Pelvic Pain in Women

Adriana P. M. S. Romão, Ricardo Gorayeb, Gustavo Salata Romão, Omero Benedicto Poli-Neto, Antonio Alberto Nogueira

Department of Gynecology and Obstetrics, School of Medicine of Ribeir?o Preto, University of S?o Paulo, Ribeir?o Preto, SP, Bra- zil;.
Department of Gynecology and Obstetrics, School of Medicine of Ribeir?o Preto, University of S?o Paulo, Ribeir?o Preto, SP, Bra- zil;Department the Surgery and Anatomy, University Hospital, Faculty of Medicine of Ribeir?o Preto, University of S?o Paulo, Ribeir?o Preto, SP, Brazil.
Department of Neurosciences and Behavioral Sciences, School of Medicine of Ribeir?o Preto, University of S?o Paulo, Ribeir?o Preto, SP, Brazil;.
Department of the Surgery and Anatomy, Uni- versity Hospital, Faculty of Medicine of Ribeir?o Preto, University of S?o Paulo, Ribeir?o Preto, SP, Brazil..
Federal University of S?o Carlos, SP, Brazil.

DOI: 10.4236/ijcm.2013.410076                

Abstract

Chronic pelvic pain (CPP) is a prevalent condition with a significant impact on the personal, social, professional and marital life of women. It is a complex condition that may have no specific causal diagnosis or may be associated with multiple diagnoses, frequently involving treatment failure. The definition of health care strategies fundamentally depends on the way women live with this condition. Thus, the objective of the present study is to learn how women with CPP experience their diagnosis and the meaning they attribute to it. A qualitative study was conducted by interviewing a focus group of 11 women. The content of the interviews was recorded and fully transcribed, and the speeches were interpreted by Bardin’s content analysis. The topics most frequently dealt with in the interview were diagnosis, beginning of pain, worsening and improving factors, marital and interpersonal relationships, interference with daily activities, association with emotional aspects, and perspectives for the future. It could be perceived how much these women need to be better heard and how much the association between psychic and physical questions must be visualized by the professionals who provide care for them. The approach used by professionals from different areas, when properly structured, can minimize the problem of the division of a sick person into separate parts. Psychological care is very important, especially in relation to the discovery of more effective strategies for living with pain.

Keywords

Lived Experience; Chronic Pelvic Pain; Qualitative Method; Women’s Health

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	ACOG., “Practice Bulletin Chronic Pelvic Pain,” Obstetrics & Gynecology, Vol. 103, 2004, pp. 589-605.
[2]	P. Latthe, et al., “WHO Systematic Review of Prevalence of Chronic Pelvic Pain: A Neglected Reproductive Health Morbidity,” BMC Public Health, Vol. 6, 2006, p. 177. http://dx.doi.org/10.1186/1471-2458-6-177
[3]	V. Grace and K. Zondervan, “Chronic Pelvic Pain in Women in New Zealand: Comparative Well-Being, Comorbidity, and Impact on Work and Other Activities,” Health Care for Women International, Vol. 27, No. 7, 2006, pp. 585-599. http://dx.doi.org/10.1080/07399330600803725
[4]	A. Romao, R. Gorayeb, G. S. Romao, O. B. Poli-Neto and A. A. Nogueira, “Impact of Chronic Pelvic Pain on Female Sexual Function,” International Journal of Clinical Medicine, Vol. 4, 2013, pp. 178-182. http://dx.doi.org/10.4236/ijcm.2013.43031
[5]	G. P. Silva, et al., “High Prevalence of Chronic Pelvic Pain in Women in Ribeirao Preto, Brazil and Direct Association with Abdominal Surgery,” Clinics (Sao Paulo), Vol. 66, No. 8, 2011, pp. 1307-1312.
[6]	P. T. Weijenborg, et al., “Clinical Course of Chronic Pelvic Pain in Women,” Pain, Vol. 132, No. 1, 2007, pp. S117-S123. http://dx.doi.org/10.1016/j.pain.2007.06.020
[7]	P. T. Weijenborg, et al., “Predictors of Outcome in a Cohort of Women with Chronic Pelvic Pain: A Follow-Up Study,” European Journal of Pain, Vol. 13, No. 7, 2009, pp. 769-775. http://dx.doi.org/10.1016/j.ejpain.2008.09.002
[8]	L. McCollum and T. Pincus, “A Biopsychosocial Model to Complement a Biomedical Model: Patient Questionnaire Data and Socioeconomic Status Usually Are More Significant than Laboratory Tests and Imaging Studies in Prognosis of Rheumatoid Arthritis,” Rheumatic Disease Clinics of North America, Vol. 35, No. 4, 2009, pp. 699-712. http://dx.doi.org/10.1016/j.rdc.2009.10.003
[9]	P. P. Souza, et al., “Qualitative Research as the Basis for a Biopsychosocial Approach to Women with Chronic Pelvic Pain,” Journal of Psychosomatic Obstetrics & Gynecology, Vol. 32, No. 4, 2011, pp. 165-172. http://dx.doi.org/10.3109/0167482X.2011.607523
[10]	A. P. Romao, et al., “High Levels of Anxiety and Depression Have a Negative Effect on Quality of Life of Women with Chronic Pelvic Pain,” International Journal of Clinical Practice, Vol. 63, No. 5, 2009, pp. 707-711. http://dx.doi.org/10.1111/j.1742-1241.2009.02034.x
[11]	A. P. Romao, et al., “Chronic Pelvic Pain: Multifactorial Influences,” Journal of Evaluation in Clinical Practice, Vol. 17, No. 6, 2011, pp. 1137-1139. http://dx.doi.org/10.1111/j.1365-2753.2010.01485.x
[12]	J. Gunter, “Chronic Pelvic Pain: An Integrated Approach to Diagnosis and Treatment,” Obstetrical & Gynecological Survey, Vol. 58, No. 9, 2003, pp. 615-623. http://dx.doi.org/10.1097/01.OGX.0000083225.90017.01
[13]	M. B. F. Gurian, A. M. de Souza, A. P. M. da Silva, Montenegro, M. L. L. de Souza Montenegro, O. B. P. Neto, F. J. C. dos Reis, A. A. Nogueira1 and J. C. Rosa e Silva, “Chronic Pelvic Pain of Musculoskeletal Cause in Women,” Expert Review of Obstetrics & Gynecology, Vol. 7, No. 2, 2012, pp. 149-157. http://dx.doi.org/10.1586/eog.12.13
[14]	M. L. L. M.-V. de Souza Montenegro, E. Cristine, C. dos Reis, F. José, R. e Silva, J. César, A. A. Nogueira, A. A. Nogueira, P. Neto and O. Benedicto, “Thiele Massage as a Therapeutic Option for Women with Chronic Pelvic Pain Caused by Tenderness of Pelvic Floor Muscles,” Journal of Evaluation in Clinical Practice, 2010, pp. 981-982.
[15]	E. R., Turato, “Qualitative and Quantitative Methods in Health: Definitions, Differences and Research Subjects,” Revista de Saúde Pública, Vol. 39, No. 3, 2005, pp. 507-514. http://dx.doi.org/10.1590/S0034-89102005000300025
[16]	J. Kitzinger, “Qualitative Research, Introducing Focus Groups,” BMJ, Vol. 311, No. 7000, 1995, pp. 299-302. http://dx.doi.org/10.1136/bmj.311.7000.299
[17]	L. Bardin, “Análise de Conteúdo,” Lisboa, P.U.d. France, 1977.
[18]	V. Grace, “Problems Women Patients Experience in the Medical Encounter for Chronic Pelvic Pain: A New Zealand Study,” Health Care for Women International, Vol. 16, No. 6, 1995, pp. 509-519. http://dx.doi.org/10.1080/07399339509516206
[19]	J. B. Zadinsky, “Experiences of Women with Chronic Pelvic Pain,” Health Care for Women International, Vol. 17, No. 3, 1996, pp. 223-232.
[20]	J. Z. Moore and S. Kennedy, “‘People Sometimes React Funny if They’re Not Told Enough’: Women’s Views about the Risks of Diagnostic Laparoscopy,” Health Expect, Vol. 5, No. 4, 2002, pp. 302-309. http://dx.doi.org/10.1046/j.1369-6513.2002.00192.x
[21]	J. Price, G. Farmer, J. Harris, T. Hope, S. Kennedy and R. Mayou, “Attitudes of Women with Chronic Pelvic Pain to the Gynecological Consultation: A Qualitative Study,” BJOG, Vol. 113, No. 4, 2006, pp. 446-452. http://dx.doi.org/10.1111/j.1471-0528.2006.00862.x
[22]	L. L. McGowan, F. Creed and C. A. Chew-Graham, “How Do You Explain a Pain That Can’t Be Seen? The Narratives of Women with Chronic Pelvic Pain and Their Disengagement with the Diagnostic Cycle,” British Journal of Health Psychology, Vol. 12, No. 2, 2007, pp. 261-274.
[23]	V. M. Grace, “Problems Women Patients Experience in the Medical Encounter for Chronic Pelvic Pain: A New Zealand Study,” Health Care for Women International, Vol. 16, No. 6, 1995, pp. 509-519. http://dx.doi.org/10.1080/07399339509516206
[24]	J. K. Zadinsky and J. S. Boyle, “Experiences of Women with Chronic Pelvic Pain,” Health Care for Women International, Vol. 17, No. 3, 1996, pp. 223-232. http://dx.doi.org/10.1080/07399339609516237
[25]	C. Savidge, et al., “Women’s Perspectives on Their Experiences of Chronic Pelvic Pain and Medical Care,” Journal of Health Psychology, Vol. 3, No. 1, 1998, pp. 103-116. http://dx.doi.org/10.1177/135910539800300108
[26]	J. Price, et al., “Attitudes of Women with Chronic Pelvic Pain to the Gynaecological Consultation: A Qualitative Study,” BJOG, Vol. 113, No. 4, 2006, pp. 446-452. http://dx.doi.org/10.1111/j.1471-0528.2006.00862.x
[27]	V. M. Grace and S. MacBride-Stewart, “‘Women Get This’: Gendered Meanings of Chronic Pelvic Pain,” Health (London), Vol. 11, No. 1, 2007, pp. 47-67. http://dx.doi.org/10.1177/1363459307070803
[28]	G. A. Cardoso, “Social Representations of Seropositivity and Treatment Adherence,” Ciência e Saúde Coletiva, Vol. 10, No. 1, 2005, pp. 151-162. http://dx.doi.org/10.1590/S1413-81232005000100022
[29]	N. W. Ambler, A. C. de C Williams, P. Hill, R. Gunary, and G. Cratchley, “Sexual Difficulties of Chronic Pain Patients,” Clinical Journal of Pain, Vol. 17, No. 2, 2001, pp. 138-145. http://dx.doi.org/10.1097/00002508-200106000-00006
[30]	T. N. Monga, G. Tan, H. J. Ostermann, U. Monga and M. Grabois, “Sexuality and Sexual Adjustment of Patients with Chronic Pain,” Disability and Rehabilitation, Vol. 20, No. 9, 1998, pp. 317-329. http://dx.doi.org/10.3109/09638289809166089
[31]	B. D. Reed, H. K. Haefner, M. R. Punch, R. S. Roth, D. W. Gorenflo and B. W. Gillespie, “Psychosocial and Sexual Functioning in Women with Vulvodynia and Chronic Pelvic Pain,” Journal of Reproductive Medicine, Vol. 45, 2000, pp. 624-632.
[32]	F. F. Verit, A. Verit and E. Yeni, “The Prevalence of Sexual Dysfunction and Associated Risk Factors in Womem with Chronic Pelvic Pain: Cross-Sectional Study,” Archives of Gynecology and Obstetrics, Vol. 274, No. 5, 2006, pp. 297-302. http://dx.doi.org/10.1007/s00404-006-0178-3
[33]	T. M. Tripoli, et al., “Evaluation of Quality of Life and Sexual Satisfaction in Women Suffering from Chronic Pelvic Pain with or without Endometriosis,” The Journal of Sexual Medicine, Vol. 8, No. 2, 2011, pp. 497-503. http://dx.doi.org/10.1111/j.1743-6109.2010.01976.x
[34]	L. Silva, “Dor Pélvica Cronica: Desafio ao Dualismo,” In FIOCRUZ, Rio de Janeiro, 2005. http://dx.doi.org/10.1590/S0004-282X2003000300017
[35]	G. P. Kurita, “Adesao ao Tratamento da dor Cronica: Estudo de Variáveis Demográficas, Terapêuticas e Psicossociais,” Arq Neuro Psiquiatr, Vol. 61, No. 2b, 2003, pp. 416-425.
[36]	C. E. Baptista and S. Fortes, “Grupoterapia e Dor Cronica,” In: J. A. B. Figueiró, G. Angelotti and C. A. de M. Pimenta, Dor & Saúde Mental, Atheneu, Sao Paulo, 2005.
[37]	L. O. Seger, “Psicologia Aplicada à Disfuncao da Articulacao Temporomandibular,” In: Psicologia e Odontologia: Uma Abordagem Integradora, Santos, Sao Paulo, 2002, pp. 203-242. http://dx.doi.org/10.1037/0735-7028.33.2.176
[38]	J. Albino, “A Psychologist’s Guide to Oral Diseases and Disorders and Their Treatment,” Professional Psychology, Research and Practice, Vol. 33, No. 2, 2002, pp. 176-182.
[39]	A. M. Matta, “A Qualitative Analysis of Living with Endometriosis,” Psicologia, Saúde & Doencas, Vol. 7, No. 1, 2006, pp. 57-72.