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  • Writer's pictureKM Hellman, PhD

Why we study menstrual pain?

Updated: Jan 31, 2019

Chronic visceral pelvic pain disorders cause substantial morbidity and cost upwards of 50 billion dollars in lost US wages and health care expenditures. Visceral pelvic pain conditions, such as endometriosis-associated pelvic pain, irritable bowel syndrome, bladder pain syndrome, are common (~25% prevalence in women), but predictable and may be preventable. The causes of visceral pain are poorly understood because diagnostic tests do not exist to distinguish pain due to primary nociceptor activation, referred abdominal muscular activity, organ perfusion, and oxygenation issues. Development of effective treatments for disruptive chronic pelvic pain conditions like dysmenorrhea and bladder pain syndrome are hindered by this lack of mechanistic understanding.

To address these limitations, I joined NorthShore University HealthSystem and created the Gynecological Research Laboratory (GyRL). Dr. Frank Tu is my primary collaborator (and also a minimally invasive surgeon specializing in pelvic pain). Dr. Tu’s expertise has been vital for recruiting and examining over 500 participants, interpreting anatomical ultrasound/MRI findings and bridging the translational science I have conducted in the GyRL. My expertise in basic pain research, computational analytical methods, paradigms for studying spontaneous pain and the science of electrophysiology was essential for the development of robust assessment of the physiological bases for pelvic pain. The innovation of my work requires clinical phenotyping to complement my research methodology and statistical modeling and this combination has been essential to discovering novel insights into female pelvic pain.

I have developed a method to study visceral pain by noninvasively evaluating physiological factors while simultaneously assessing spontaneous pain. This approach has led to the identification of how uterine and non-uterine components contribute to menstrual pain. There are few other laboratories dedicated to eradicating dysmenorrhea, one of the most frequent causes of suffering and gender disparity worldwide. Early attention to pain evolution is essential if we are to transform current, antiquated tertiary care paradigms in chronic pain management, including opioid use, which have produced the worst health epidemic of the decade.

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