Combined Hormonal Contraceptives for Pelvic Pain: Ineffectiveness or Discontinuation due to Side-effects
CANSAGE ePoster Library. Williams C. 09/26/19; 275268; eP-135
Christina Williams
Christina Williams
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Abstract
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Objective: To investigate use patterns and factors associated with combined hormonal contraceptives (CHC) ineffectiveness for pain treatment or discontinuation due to side-effects in patients with pelvic pain.Methods: Cross-sectional analysis of a prospective registry (Endometriosis Pelvic Pain Interdisciplinary Cohort-EPPIC-ClinicalTrials.gov#NCT02911090). Patients were recruited between December 2013 to February 2017 from the BC Women's Center for Pelvic Pain and Endometriosis. Inclusion criterion was 18-49 years who completed the registry questionnaire and who had a physical examination. Patients reported whether they had history of CHC ineffectiveness or discontinuation due to side effects. These variables were tested for an association with severity of chronic pelvic pain (CPP, 0-10), as well as other pelvic pain scores, quality-of-life, and underlying pain conditions.Results: Worse CPP severity in the last 3 months was associated with a history of CHC ineffectiveness whether cyclical (p = 0.008) or continuous (p = 0.001). Amongst the underlying conditions, pelvic floor tenderness (as a marker of pelvic floor myalgia) was associated with CHC ineffectiveness, again whether cyclical (p = 0.034) or continuous (p = 0.042). In addition, poorer quality-of-life was present in women who reported a history of CHC discontinuation due to side effects, for both cyclical (p = 0.042) or continuous (p = 0.006). Conclusion: A history of combined hormonal contraceptive (CHC) ineffectiveness for pain treatment was associated with worse chronic pelvic pain and pelvic floor tenderness, which suggests myofascial or nervous system contributors to chronic pelvic pain that do not respond to hormonal suppression.
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