Prevalence and impact of comorbidities in women with chronic pelvic pain

Abstract

BACKGROUND AND OBJECTIVES: Chronic pelvic pain (CPP) is a common condition in women and there are often associated comorbidities. The objective of this study was to evaluate the prevalence of comorbidities in patients with CPP and to seek associations between comorbidities and the manifestations of chronic pain. METHODS: Observational case-control study with sociodemographic, behavioral and clinical information, including comorbidities, in 246 women, 123 with CPP and 123 without CPP (control group). RESULTS: Anxiety, depression, migraine and endometriosis were the most frequent comorbidities in women with CPP. The comorbidities assessed in the CPP group were not associated with pain intensity score, history of abortion, physical violence or sexual violence (p>0.05). In the group of women with CPP and endometriosis, the median anxiety and depression score was significantly lower than in the group without endometriosis (14.5; 95% CI: 11.0-14.9) versus (17.0; 95% CI: 14.6-16.7), p=0.012 and (13.0; 95%CI: 11.1-15.9) versus (16.5; 95% CI: 14.5-17.6), p= 0.045, respectively. In patients with migraine, the median depression score was higher in the group of women with CPP compared to the group without CPP (15.0; 95% CI: 14.1-17.8) versus (10.0; 95% CI: 8.5-12.4), p=0.048. CONCLUSION: The most prevalent comorbidities in women with CPP were mental disorders, migraine and endometriosis. Comorbidities were not related to pain intensity, physical violence or sexual violence. Having a diagnosis of endometriosis is associated with lower anxiety and depression scores in patients with CPP. Overlapping migraine and CPP were associated with a worse depression score.

Keywords

• chronic pain
• comorbidity
• endometriosis
• pelvic pain