Pelvic pain in women is a commonly occurring and poorly understood complaint that causes substantial physical limitation and emotional distress. Many diseases and syndromes can cause or contribute to pelvic pain, and this complexity can complicate and delay diagnosis. In addition, effective treatments are limited. Moreover, treatment needs to address all contributors to pain as well as pain itself. The NICHD conducts and supports research on both gynecologic and non-gynecologic disorders associated with pelvic pain, with the ultimate goal of reducing morbidity among women through prevention or improved treatment.
Institute Activities and Advances
NICHD research efforts that are both directly and indirectly related to pelvic pain are ongoing. For instance, some NICHD research is aimed at investigating the etiology and treatment of disorders that can cause or contribute to pelvic pain, including endometriosis, uterine fibroids, vulvodynia, and pelvic floor disorders. Other research is looking at mechanisms of and contributors to pain related to these disorders.
For example, research, including clinical trials, conducted through the NICHD's Unit on Reproductive Endocrinology and Infertility (UREI), part of the Division of Intramural Research in the Program in Reproductive and Adult Endocrinology, is investigating various aspects of chronic pelvic pain related to endometriosis. Areas explored include (but are not limited to) the pathophysiology of pain, the relationship between pain location and endometriosis lesions, and the effects of endometriosis-related pain on quality of life. The UREI also conducts research on several aspects of uterine fibroids, including gene regulation and cellular growth factors. Notably, the unit recently completed a collaborative clinical trial of a minimally invasive treatment of uterine fibroids.
Research related to pelvic pain also is supported through various organizational units within the Division of Extramural Research. For example, the Gynecological Health and Disease Branch (GHDB) sponsors studies investigating the role of genetics and hormone exposure in vulvodynia, as well as efforts to develop standardized measures for diagnosis and outcome measurements. The GHDB also sponsors research and clinical trials of treatments for endometriosis, vulvodynia, and other pain-related disorders.
The Institute also led efforts to create the NIH Research Plan on Vulvodynia (PDF - 746 KB) (Full Site), which lays out a scientific agenda for the NIH to conduct and gather rigorous scientific evidence needed to answer questions and fill in knowledge gaps about vulvodynia,a primary symptoms of which is pelvic pain.
The GHDB also supports the Pelvic Floor Disorders Network (Full Site) to encourage collaborative research on pelvic floor disorders and to improve patient care.
Other Activities and Advances
Pelvic pain often has more than one cause, and this complexity is the reason why the NICHD collaborates with other NIH Institutes and pain research groups. Specifically:
- The NICHD is an active member of the NIH Pain Consortium, which was established to enhance pain research and promote collaboration among researchers across the many NIH Institutes and Centers that have programs and activities addressing pain.
- The Institute also participates in the Trans-NIH Overlapping Chronic Pain Conditions Working Group, which was formed in 2011 and brings together program directors from 12 Institutes and Centers involved in pain research as well as external members from pain advocacy groups.
- In 2013, the World Endometriosis Society Montpellier Consortium published the first-ever worldwide consensus statement on the management of endometriosis. The statement, published in the journal Human Reproduction, addresses 69 issues related to the management of endometriosis. NICHD scientists and grantees were among those on the Consortium. Visit Global Consortium Identifies Best Management of Endometriosis for more information.