Pelvic Pain
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The EXPPECT Pelvic Pain Service consists of a multidisciplinary team that aims to provide high quality, evidence-based and patient-centred management of pelvic pain.

This website has been designed by Chris Graham, with the support of EXPPECT Pelvic Pain clinic staff at NHS Lothian and the University of Edinburgh, to provide you with up-to-date factual information about pelvic pain and possible treatments.

EXPPECT outreach

In this webinar, EXPPECT clinical experts Dr Lucy Whitaker and Dr Lorraine Harrington discuss identifying pelvic pain and potential causes, communicating pain with your doctor and treatment options. You can also listen to one patient’s experience of the EXPPECT Pelvic Pain Management Programme. View the webinar below:

Professor Andrew Horne contributed to a panel discussion at Fondation L’Oréal’s 'For Women in Science' Festival on 7 December 2021, on the topic "Unbiased health solutions for the future”. View the panel discussion below:

EXPPECT in the media

Professor Andrew Horne and colleagues from the University of Oxford contributed to an important article in The Guardian: A common treatment for endometriosis could actually be making things worse - repeat surgeries for endometriosis could be exacerbating pain symptoms.

Until recently, doctors treated all cases of endometriosis with the same approach, usually involving surgery. But evidence now shows that the best treatment depends greatly on which of the three kinds of disease [superficial peritoneal endometriosis, cystic ovarian endometriosis (or endometrioma) and deep endometriosis] a patient has, and the type of endometrial-like tissue that is found. [...] We find that patients don’t always get better with surgery, and those who do often feel better for a very short time. [...] 

Professor Andrew Horne(Source: The Guardian, July 2021)

The ovarian strand of the disease involves clumps of errant tissue growing in the ovaries, which commonly form cysts that can burst and cause severe pain and inflammation. Patients with this strand are likely to experience significant relief from the removal of these cysts, so surgery is often necessary.

However, 80% of endometriosis sufferers have superficial peritoneal disease and, in these patients, it is less likely that the errant tissue itself is causing the majority of a patient’s pain and symptoms. Instead, the way that the diseased tissue interacts with nerves in the pelvis is usually the main culprit. In these cases, surgery could actually be making things worse by exacerbating nerve pain.

In September 2020, EXPPECT-led pelvic pain research, published in The Lancet, received widespread media coverage including in The Telegraph and STV News:

The Telegraph: Common drug for chronic pelvic pain no better than placebo, study finds [subscription / free trial]

STV News: Pelvic pain drug ‘no more effective than a placebo’

We have been prescribing this drug [gabapentin] for many years with little evidence of its effectiveness. As a result of our study, we can confidently conclude that gabapentin is not effective for chronic pelvic pain in women where no cause has been identified. More research is needed to explore if other therapies can help instead.

Professor Andrew Horne(From STV News)

Research Article: Gabapentin for chronic pelvic pain in women (GaPP2): a multicentre, randomised, double-blind, placebo-controlled trial. doi: 10.1016/S0140-6736(20)31693-7

Endometriosis: The Experts' Guide

Professor Andrew Horne and Carol Pearson have co-authored a practical patient guide to endometriosis

Launched on 5th March 2018, "Endometriosis: The Experts’ Guide to Treat, Manage and Live Well with Your Symptoms" written by Professor Andrew Horne and Carol Pearson (Endometriosis UK Patient Leader) is available from Amazon.

Moneys raised by book sales will go to Endometriosis UK.

Support for EXPPECT

Endo Warriors Cheque Presentation

Support from Endo Warriors

EXPPECT were delighted to receive a generous donation for our research into improving the care of women with endometriosis from the Endo Warriors.

Candice and Claire presented the cheque to Andrew and Philippa, on behalf of Endo Warriors, on Monday 29 July 2019.

Thank you to Endo Warriors and everyone who took part in the fundraising!

£100,000 for pain management research from The Charles Wolfson Charitable Trust

The Charles Wolfson Charitable Trust has donated £100,000 to EXPPECT to support our research into pain management for women with endometriosis.

The Charles Wolfson Charitable Trust is a charity awarding grants to support the fields of medicine, education and welfare.

Professor Andrew Horne explains how this donation will support EXPPECT's vital research into endometriosis in an Edinburgh Friends magazine article: 

The £100,000 from The Charles Wolfson Charitable Trust will cover the cost of a research scientist who will work with us to identify potential drug targets that could lead to a better way of managing pain and related symptoms

Professor Andrew Horne(Adapted from Edinburgh Friends magazine article, 2018)

Funding for a prescribing physiotherapist

Edinburgh and Lothians Health Foundation

The Edinburgh and Lothians Health Foundation has approved funding to pilot a prescribing physiotherapist at EXPPECT.

The Edinburgh and Lothians Health Foundation aims to improve the physical and mental health of the people of Scotland, in particular in Edinburgh and the Lothians. It provides funding and makes grants to support projects and initiatives not normally funded by the health service.

Photo of the EXPPECT Edinburgh team