title: Prevalence and use of complementary health approaches among women with chronic pelvic pain in a prospective cohort study.
abstract: OBJECTIVE
  The aim of this study was to examine the prevalence of and factors associated with use of complementary health approaches among women with chronic pelvic pain (CPP).
  
  
  METHODS
  We analyzed data from the Study of Pelvic Problems, Hysterectomy, and Intervention Alternatives, a prospective cohort study of women seeking care for noncancerous pelvic problems with intact uteri at enrollment. Among a subset of 699 participants who reported having CPP, we analyzed the prevalence of complementary health approaches used and associated patient sociodemographic and clinical characteristics, health-related quality of life, attitudes and beliefs, and conventional health care practices.
  
  
  RESULTS
  At baseline, slightly over one-half (51%) of women with CPP used at least one complementary health approach in the past year, including acupuncture (8%), special foods or diets (22%), herbs (27%), and vitamins and minerals (29%). During follow-up surveys conducted annually for 4 years, a substantial proportion of women (44.8%) used complementary health approaches at more than half of the assessments. Users of complementary health approaches were more likely to undergo a hysterectomy or oophorectomy or to use gonadotropin-releasing hormone agonists or opioids during the study compared with nonusers. Women with CPP who used complementary health approaches also had more optimal health-related quality of life measured by the Pelvic Problem Impact Questionnaire (31.6 vs 25.6, P < 0.001).
  
  
  CONCLUSIONS
  Many women with CPP consistently use complementary health approaches. The substantial interest in and high prevalence of complementary health approaches used alongside conventional medical approaches highlight the need for better understanding of multimodal approaches to address the complex condition of CPP.
authors.affiliation: Osher Center for Integrative Medicine, University of California, San Francisco, San Francisco, California, USA.
authors.forename: Maria T
authors.initials: MT
authors.lastname: Chao
authors.forename: Priscilla D
authors.initials: PD
authors.lastname: Abercrombie
authors.forename: Sanae
authors.initials: S
authors.lastname: Nakagawa
authors.forename: Steven E
authors.initials: SE
authors.lastname: Gregorich
authors.forename: Lee A
authors.initials: LA
authors.lastname: Learman
authors.forename: Miriam
authors.initials: M
authors.lastname: Kuppermann
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000628:therapy; D015331:Cohort Studies; D000529:Complementary Therapies / Q000379:methods*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D008969:Molecular Sequence Data; D017699:Pelvic Pain / Q000628:therapy*; D012959:Socioeconomic Factors
keywords: Chronic Pelvic Pain; Complementary Health Approaches; Complementary Medicine; Integrative Medicine