Women's Health

Noncancerous pelvic problems are linked to poor quality of life and sexual functioning for premenopausal women

Noncancerous pelvic conditions, which typically cause heavy bleeding and pelvic pain and pressure, are associated with problems in sexual functioning and poor health-related quality of life among premenopausal women. In addition, women who are experiencing these symptoms are not particularly satisfied with the treatments offered them, according to a new study.

Miriam Kuppermann, Ph.D., M.P.H., of the University of California, San Francisco, and colleagues examined the treatment and outcomes of 1,493 women who sought care for noncancerous pelvic problems and who had not undergone hysterectomy. They asked the women about their symptoms, attitudes, quality of life, sexual functioning, and treatment satisfaction.

Most women (83 percent) reported no or only partial symptom resolution from treatment. Also, 42 percent of women said that their pelvic problems interfered with their ability to have and enjoy sex. The women's physical and mental health scores were similar to those that have been reported for women with chronic hepatitis C, and were substantially lower than population norms for women aged 40 to 49 years. Their quality of life was sufficiently diminished, and they were as willing to trade a similar amount of time in their current health state for less time in perfect health as were primary care patients with depression and rheumatoid arthritis.

Satisfaction with treatment for their pelvic problems ranged from 31 percent for progestin intrauterine devices to 58 percent for opiates. Satisfaction with uterine-preserving surgery ranged from 20 percent for dilation and curettage to 51 percent for surgery to remove uterine fibroids. Over one-fourth (28 percent) of the women who used acupuncture were satisfied.

Women with less education, greater symptom resolution, and who were experiencing less interference of pelvic problems with sex were more likely to be satisfied with the treatment they received. The study was supported in part by the Agency for Healthcare Research and Quality (HS09478, HS11657, and HS07373).

See "Effect of noncancerous pelvic problems on health-related quality of life and sexual functioning," by Dr. Kuppermann, Lee A. Learman, M.D., Ph.D., Michael Schembri, B.S., and others, in the September 2007 Obstetrics & Gynecology 110(3), pp. 633-642.

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