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Several types of medication are used to treat chronic pelvic pain (CPP) and manage the symptoms. Pain killers are used most often, to manage the pain. Other medications used include antidepressants and anticonvulsants. If the underlying cause of your pelvic pain is an infection, your doctor may prescribe antibiotics. The most effective strategy might be to use a combination of medications.

Pain Medications

Many women and their physicians are understandably wary of pain medications and their potential side effects. Ideally, your pain could be controlled without the use of these medications; however, they are often part of the strategy, at least during the initial stages of treatment. Pain relieving medication can help to relieve your pain until other slower therapies take affect.

Nonsteroidal anti-inflammatory drugs (NSAIDS) are the type of pain control most of us are familiar with. Aspirin and Advil are examples of NSAID drugs. There is little danger of becoming dependent on these drugs; however, they can have other side effects, including gastrointestinal upset, heartburn, ulcers and skin rashes.

Stronger pain relieving medications are called opioids. These drugs can relieve more severe pain than the NSAIDS, but they also have greater risks. Opioid drugs, such as codeine and morphine, may make you feel sleepy and disoriented. An overdose of these drugs can be extremely dangerous and there is a risk of dependency if used regularly.

Opioid drugs often cause constipation and changes in the motility of the bowel, which can contribute to pelvic pain. Women who have used opioid drugs over a period of time, to control pain, may not be aware of how the drugs are alterating their bowels. It is important to distinguish pain that may be arising from the bowel from pain that may be caused by other problems. To do so, your doctor may suggest that you discontinue your opiate medication, and take steps to restore normal bowel motility (see also page on irritable bowel syndrome).

Your doctor will likely recommend that you take opioid medication at a particular time each day rather than in response to a specific pain. This method has been shown to relieve pain more effectively and makes it less likely that you will become addicted to the medication.

Other side effects of opioids include constipation, nausea, vomiting, itching, mental confusion and urinary retention. You should never drink alcohol or drive while using opioids.

Antidepressants and Anticonvulsants

Antidepressants and anticonvulsants are used to treat neuropathic pain in women who have CPP and vulvodynia (pain in the vulva).

Although originally developed to treat epilepsy, anticonvulsant drugs are now used in a number of situations where nerve damage causes pain. The drugs may relieve pain by making the nerves less sensitive to stimulation.

Tricyclic antidepressants work by limiting the pain signals that damaged nerves send to the brain. They are an older class of antidepressants, which have more side effects than new antidepressants, such as Prozac; however, they appear to be more effective at treating CPP and vulvodynia. You are not being prescribed an antidepressant because the doctor thinks your condition is 'in your head.' These drugs modify how signals from the nerves are received.


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