Coping methods for endometriosis-associated acyclic pelvic pain vary by age group

Key takeaways:

• Top methods were sleep and music for teens, laxative/enema for young adults and yoga for adults.
• Conditions worsening pain were exercise for adolescents, stress for younger adults, and sex or orgasm for adults.

Coping methods for acyclic pelvic pain associated with endometriosis vary by age group, with adolescents reporting sleep and music as most helpful and exercise as less helpful, researchers reported in Frontiers Reproductive Health.

“Women with endometriosis-related pain often seek out strategies to augment or supplement these standard surgical, hormonal and analgesic treatments,” Jennifer M. Mongiovi, PhD, postdoctoral research fellow in the department of epidemiology at the Harvard T.H. Chan School of Public Health and the department of obstetrics, gynecology and reproductive biology at Brigham and Women’s Hospital and Harvard Medical School, and colleagues wrote. “Acyclic pelvic pain, or pelvic pain occurring at times other than with menses, can be challenging to manage since it is associated with flares that are much less predictable than other symptoms.”

Mongiovi and colleagues conducted an analysis of data from 357 participants (median age, 19 years) with laparoscopically confirmed endometriosis from the longitudinal cohort of the Women’s Health Study: From Adolescence to Adulthood (A2A). All women completed a World Endometriosis Research Foundation (WERF) Endometriosis Phenome and Biobanking Harmonization Project (EPHect) compliant questionnaire during the study period and reported acyclic pelvic pain in the previous 3 months. All participants were asked to indicate specific methods or activities that helped or worsened pain. Researchers evaluated differences among age groups of adolescents younger than 18 years, young adults aged 18 to 25 years and adults older than 25 years.

The most reported alternative coping method for acyclic pelvic pain was heating pad use (73.9%), lying down (69.7%) and sleep (46.3%). However, 12.6% of participants reported that no methods helped with pain.

Adolescents, compared with younger adults and adults, respectively, more frequently reported sleep (57.3% vs. 44% and 31.1%; P = .004) or use of music (21.1% vs. 7% and 9.1%; P = .001) as a coping method for pain. More younger adults reported laxatives/enema use to manage pain compared with adolescents and adults (9.8% vs. 6.6% and 1.3%; P = .04), respectively. Adults more commonly reported practicing yoga to manage pain compared with younger adults and adolescents (14.8% vs. 11% and 3.9%; P = .04) respectively.

The most reported methods that worsened pain were stress (59.1%), constipation (52.9%) and exercise (49.3%). Adolescents most frequently reported exercise as a method that worsened acyclic pelvic pain (59.9%), followed by younger adults (46.9%) and adults (35.1%; P = .002). Younger adults most frequently reported stress worsening pain compared with adolescents and adults (69.2% vs. 56.2% and 45.5%; P = .002), respectively. Adults most frequently reported intercourse (51.9% vs. 37.1% and 7.3%; P < .0001) and orgasm (20.8% vs. 8.4% and 4.4%; P = .0009) as methods that worsened pain compared with younger adults and adolescents, respectively.

“This information may be especially useful for health care practitioners to provide information and support for patients as they manage this highly complex and poorly understood condition,” the researchers wrote. “Future studies should aim to provide information that will further inform decisions in making care plans for managing acyclic pelvic pain, particularly endometriosis-associated pain, that is effective, accessible and tailored to the preferences of the patient.”