Therapeutic effects of antidepressants and Kampo medicines on chronic pelvic pain in women

Chronic pelvic pain is a common and significant disorder among women. However, its etiology is not clear, and effective treatments remain inconclusive. The present study was designed to investigate the efficacy of antidepressants and Kampo medicines, which have been applied for other pain disorders, to treat chronic pelvic pain in women. Twenty-nine gynecological outpatients received pharmacological treatments. None of the patients had clear organic abnormalities that could explain their pain, nor did they have menstruation-related disorders. After considering severity of pain and clinical and psychosocial conditions for each patient, the medication and its administration was determined. Pain severity decreased in patients with antidepressants, which have been demonstrated to alleviate general chronic pain modulating through the descending pain inhibitory system. Kampo medicines such as Shuji-bushi, Sanyaku and Takusha also mitigated pain in patients. Our findings suggest that chronic pelvic pain, especially vulval pain, is difficult to treat, but administration of appropriate medication is effective and adjuvant analgesics could eliminate the symptoms. The present study further implies that a suitable pharmacological therapy, together with a psychological one-if necessary-is crucial in effectively treating chronic pelvic pain, which might induce depression and, ultimately, deteriorate quality of life.