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| GENDER DIFFERENCES IN CHRONIC PAIN SYNDROMES OF THE REPRODUCTIVE ORGANS Ursula Wesselmann M.D., Departments of Neurology and Biomedical Engineering, Blaustein Pain Treatment Center, Johns Hopkins University School of Medicine, Baltimore, Maryland One of the most vexing problems for gynecologists and urologists is managing patients with chronic pain syndromes of the reproductive organs, because the majority of these patients have few, if any significant findings on examination, and well-defined, effective treatments are lacking. The incidence and prevalence of these chronic pain syndromes is not known. The patients are often embarrassed to talk about their chronic pain problem. We have recently completed a clinical study aimed at two questions: (1) Are chronic pain syndromes of the reproductive organs unique to women, or do such pain syndromes also occur in men? (2) Can pain medications, which are currently available for the treatment of other chronic pain syndromes, be successfully used for chronic pain syndromes of the reproductive organs? Over the last three years we have collected outcome data on 39 women and 25 men with chronic non-malignant pain syndromes of the reproductive organs, who were enrolled in a multidisciplinary diagnosis and treatment program at Johns Hopkins Hospital. Our clinical data demonstrate that chronic pain syndromes of the reproductive organs occur in both women and men. Surgical treatment options rarely result in satisfactory pain relief in both groups. Medical treatments used for other neuropathic pain syndromes provide effective pain relief when applied to men with chronic pain syndromes of the reproductive organs. In contrast, these treatment approaches were rarely effective in women with chronic pelvic pain. Thus there is urgent need to develop improved treatment strategies for women with chronic pelvic pain, based on a better understanding of the pathophysiological mechanisms of chronic pelvic pain.
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