Dr Karen Joseph 

Gynaecologist and Specialist Pain Medicine Physician, Pelvic Pain NZ 

Karen is a Gynaecologist and Specialist Pain Medicine Physician in Christchurch, New Zealand.

In pursuit of providing best evidence based care for those living with pelvic pain she has completed specialist training and registration in Pain Medicine, Obstetrics & Gynaecology and Sexual & Reproductive Health. She is the only doctor in Australasia with this broad expertise.

Her research interests are exploring and developing ways to meet the unmet needs of those living with pelvic pain. She also teaches as a senior clinical lecturer at the University of Otago, chairs the New Zealand Pain Society Pelvic Pain SiG and sits on a number of committees to advocate for improvement in services for those who live with pain. 

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When In Doubt Cut It Out. Why is Pelvic Pain Management Stuck in Antiquity?

Persistent pain perceived in structures related to the pelvis is recognised internationally as posing a huge burden on sufferers, their families and health services. While the understanding and evidence base around persistent pain has moved on immensely in the last decade, the approach to pelvic pain largely remains stuck in the distant past. As a result success and satisfaction rates of treatment are poor, with the WHO describing it as ‘a neglected reproductive health morbidity.

Why is this and what can we as a Society do to bring care for those living with pelvic pain into the 21st century?

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PIPPI, A Small Group IDT Pain Self-Management Programme for Women with Pelvic Pain
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Small group pain self-management programmes are recognised as an effective and efficient treatment to improve physical function and psychosocial outcomes, reduce medication use and acute hospital admissions. While many of the existing  programmes are open to women with pelvic pain, despite similar pain related disability to the whole cohort this subgroup have poorer outcomes.

Reasons for this may include that women with pelvic pain identify different goals and do not feel comfortable sharing intimate details in a mixed group setting. A specialised small group PMP can overcome these barriers and demonstrate positive outcomes for this population.