Abstract
BackgroundChronic pelvic pain (CPP) in women is persistent, intermittent cyclical and non-cyclical lower abdominal pain, lasting for more than 6 months. Traditional Chinese Medicine (TCM) is a popular treatment option for women’s health conditions, but little is known about how treatment for CPP is delivered by TCM practitioners. The aim of this survey was to explore practitioners understanding and treatment of women with CPP, and how they integrate their management and care into the health care system.MethodAn online cross-sectional survey of registered TCM practitioners in Australia and New Zealand between May and October 2018. Survey domains included treatment characteristics (e.g. frequency), evaluation of treatment efficacy, referral networks, and sources of information that informed clinical decision making.ResultsOne hundred and twenty-two registered TCM practitioners responded to this survey, 91.7% reported regular treatment of women with CPP. Treatment decisions were most-often guided by a combination of biomedical and TCM diagnosis (77.6%), and once per week was the most common treatment frequency (66.7%) for acupuncture. Meditation (63.7%) and dietary changes (57.8%) were other commonly used approaches to management.The effectiveness of treatment was assessed using multiple approaches, most commonly pain scales, (such as the numeric rating scale) and any change in use of analgesic medications. Limitations to TCM treatment were reported by over three quarters (83.7%) of practitioners, most commonly due to cost (56.5%) and inconvenience (40.2%) rather than safety or lack of efficacy. Sources informing practice were most often Integration within the wider healthcare system was common with over two thirds (67.9%) receiving referrals from health care providers.ConclusionTCM practitioners seeing women with various CPP symptoms, commonly incorporate both traditional and modern diagnostic methods to inform their treatment plan, monitor treatment progress using commonly accepted approaches and measures and often as a part of multidisciplinary healthcare for women with CPP.
Highlights
Chronic pelvic pain (CPP) in women is defined as intermittent and continuous, cyclical and non-cyclical lower abdominal pain, lasting for more than 6 months [1, 2]
Given the limited evidence on this topic, this study aims to explore Traditional Chinese Medicine (TCM) practitioner knowledge and the clinical approach to managing women with CPP and integration of TCM clinical practice in Australia and New Zealand
Participants were recruited through three professional associations; the Australian Acupuncture and Chinese Medicine Association (AACMA), the Federation of Chinese Medicine and Acupuncture (FCMA), and Acupuncture New Zealand
Summary
Chronic pelvic pain (CPP) in women is defined as intermittent and continuous, cyclical and non-cyclical lower abdominal pain, lasting for more than 6 months [1, 2]. It is characterised by diverse pain symptoms including dysmenorrhea, dyspareunia, dyschezia and dysuria as well as considerable fatigue and negative impacts on mental health [3, 4]. Endometriosis and vulvodynia are two of the most commonly diagnosed causes of CPP in women of reproductive age, with estimated lifetime prevalence rates for endometriosis of approximately 11% in Australia [13] and 8–16% for vulvodynia, [14, 15]. The aim of this survey was to explore practitioners understanding and treatment of women with CPP, and how they integrate their management and care into the health care system
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