Treating chronic pelvic pain in women

This review concludes that the progestogen, medroxyprogesterone acetate, is associated with a reduction of pain at the end of treatment, but the benefit is not sustained nine months post treatment. One trial comparing goserelin with progesterone suggests possible beneficial effects for goserelin up to one year. Counseling supported by ultrasound scanning is associated with reduced pain and improvement in mood. A multidisciplinary approach is beneficial only for some outcome measures. Dihydroergotamine and adhesiolysis do not result in an improved outcome, although the former is not a current therapy.

The review methodology was sound and it included a wide range of available studies. For treatment with medroxyprogesterone acetate two studies were included, but for the other interventions only single studies were identified. It was surprising to see the small number of subjects in the studies and the limited number of studies available on this subject. The quality of some of the studies was inadequate. As noted by the reviewers, the small number of studies and the small number of participants in these trials were a major limitation of the review.

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