Pharmacological Treatment of Pelvic Pain

Abstract

The pharmacologic treatment of chronic pelvic pain requires knowledge about several classes of drugs. The standard approach is to use non-opioid drugs such as non-steroidal anti-inflammatory drugs or acetaminophen initially with or without non-opioid adjuvants (or adjuncts). Adjuvant therapy may include anticonvulsants, antidepressants, or a combination of both. Opioids are appropriate, safe, and effective in the treatment of non-cancer chronic pain. When initiating opioid therapy, patients should achieve a stable opioid dose with in a few months and thereafter be monitored regularly for pain relief, functionality, and side effects. Physicians who prescribe opioids should have an understanding of addiction, pseudoaddiction, tolerance, and dependence.