Pain severity and analgesic utilization in women with pelvic venous disorders: A secondary analysis of cross-sectional survey data

Objective Pelvic venous disorders (PeVD) are an underdiagnosed cause of chronic pelvic pain in women, and limited evidence exists regarding how PeVD pain severity is associated with treatment utilization. This study evaluated the associations between pain intensity and utilization of pharmacologic and non-pharmacologic interventions, as well as the presence of concurrent gynecologic diagnoses, in adult women with PeVD. Methods Secondary analysis of cross-sectional survey data from 160 women with PeVD was conducted. Participants provided detailed, open-ended responses regarding over-the-counter (OTC) and prescription medication use, non-pharmacologic strategies (e.g., pelvic floor therapy, acupuncture, yoga, and behavioral interventions), and concurrent gynecologic diagnoses. Pain severity was identified using latent classes discussed in a previously published manuscript from the same sample. These latent classes categorized pain descriptors by intensity, functional impact, and affective qualities into two categories: mild and severe. Chi-square analyses were performed to compare treatment utilization and comorbidity prevalence across severity groups. Results Of 160 participants, 55.6% were identified as experiencing severe pain and 44.4% as experiencing mild pain. Participants with severe pain were significantly more likely to report controlled substance use than those with mild pain (34.4% vs 15.7%, p = .008). In contrast, OTC medication use, non-pharmacologic strategies, and concurrent gynecologic diagnoses did not differ significantly between pain intensity groups. Conclusions Pain severity in women with PeVD is associated with increased controlled substance use, whereas OTC medication use, non-pharmacologic strategies, and concurrent gynecologic comorbidities did not differ by pain severity. These findings highlight differences in treatment utilization across pain severity groups and support the need for comprehensive pain assessment in women with PeVD. Further research is needed to determine whether management strategies should differ according to pain severity.