Complementary Approaches for Military Women with Chronic Pelvic Pain: A Randomized Trial.

Introduction: Active duty (AD) women suffer with chronic pelvic pain (CPP) while providers tackle diagnoses and treatments to keep them functional without contributing to the opioid epidemic. The purpose of this randomized trial was to determine the effectiveness of noninvasive, self-explanatory mindfulness-based stress reduction (MBSR) or self-paced healthy lifestyle (HL) interventions on CPP in AD women. Methods: A 6-week, interventional prospective study with AD women aged 21-55 years at Mountain Home (MTHM), Idaho, was conducted. Women were randomly assigned to MBSR (N = 21) or HL (N = 20) interventions. The primary outcome was pain perception. The secondary outcomes were depression and circulating cytokine levels. Results: Women in the MBSR group exhibited reduced pain interference (p < 0.01) and depression (p < 0.05) alongside decreased interleukin (IL)-4 (p < 0.05), IL-6 (p < 0.05), eotaxin (p < 0.05), monocyte chemoattractant protein-1 (p = 0.06), and interleukin-1 receptor antagonist (IL-1ra) (p < 0.01) and increased vascular endothelial growth factor (p < 0.05). Women in the HL group did not have changes in pain; however, they did exhibit reduced depression (p < 0.05) alongside decreased granulocyte-macrophage colony-stimulating factor (p < 0.05) and increased tumor necrosis factor alpha (p < 0.05), stromal cell-derived factor-1 (p < 0.01), and IL-1ra (p < 0.01). Conclusions: AD women receiving MBSR or HL had reduced depression scores and altered circulating cytokine levels; however, only those receiving MBSR had reduced pain perception. Findings support MBSR as an effective and viable behavioral treatment for AD women suffering from CPP and provide premise for larger randomized controlled studies. Clinical Trial Registration: MOCHI-An RCT of mindfulness as a treatment for CPP in AD Women NCT04104542 (September 26, 2019).

Mindfulness-Based Stress Reduction for Military Women With Chronic Pelvic Pain: A Feasibility Study.

INTRODUCTION: One of the most common reasons women seek gynecologic health care services is for chronic pelvic pain (CPP) and women in the military are no exception. For women diagnosed with CPP, the burden can be difficult as they struggle to perform military obligations. A chronic low-grade systemic disease believed triggered by inflammation, CPP is difficult to diagnose and treat. With limited treatment strategies available, this study sought to examine the feasibility of implementing a mindfulness-based stress reduction (MBSR) program in a military population. METHODS: This prospective study evaluated the feasibility of a standard 8-week MBSR training program in a population of active duty women previously diagnosed with CPP (N = 15). Participants also completed the Kentucky Inventory of Mindfulness survey and the Brief Pain Inventory, did home practice and kept a daily diary. Vaginal swabs were obtained at baseline and at study completion. CONCLUSIONS: A standard MBSR program is difficult to implement in a military population; other delivery formats should be considered. There was a trend suggestive that program participation promotes mindfulness, reduces pain, and promotes modulation of select pro-inflammatory cytokines. On the basis of results of this pilot feasibility study, further research is warranted.