Assessment of cardiovascular autonomic functions in women with chronic pelvic pain

Abstract

Background: Chronic pelvic pain (CPP) is a prevailing chronic painful condition in
reproductive age group women. CPP is a burden on women with significant detrimental effects on health and personal life. Autonomic dysfunction is associated with several chronic painful conditions. However, there is limited knowledge of the autonomic status of women with chronic pelvic pain.
Aim: To study the effect of CPP on cardiovascular autonomic function in women. Settings and Design: An analytical cross-sectional study.
Subjects and Methods: we recruited (n=60) patients of CPP in the age group of 18–45 years
from the Gynecology outpatient department. The control group (n=30) comprised of age matched healthy 30 female attendants. Outcomes measures: Non-invasive cardiovascular autonomic tests performed were: Basal heart rate variability, E/I ratio: Heart rate variation with respiration, 30:15 ratio: Heart rate response to standing, Postural challenge tests, Cold pressor test, Sustained handgrip test. Statistical Analysis: Unpaired t-test, p-value < 0.05 was considered significant.
Results: The values of BHRV, E:I ratio, and 30:15 ratio were found to be significantly lower
in the CPP patients compared to controls. The rise in diastolic blood pressure during SHT and
CPT was significantly higher in CPP patients as compared to controls (p < 0.001) suggesting
sympathetic over-reactivity in CPP patients.

Conclusions: From our study involving autonomic function testing on CPP patients, it was
concluded that CPP patients have decreased parasympathetic tone and increased sympathetic
tone compared to normal controls.