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American Family Physician July 1, 2000 Nancy A. Phillips	Female Sexual Dysfunction: Evaluation and Treatment Sexual dysfunction includes desire, arousal, orgasmic and sex pain disorders (dyspareunia and vaginismus). Primary care physicians must assume a proactive role in the diagnosis and treatment of these disorders...
Nurse Practitioner January 2009 Clair Kaplan	Assessing & Managing Female Sexual Dysfunction NPs can be important first-line, healthcare providers for women with FSD.
American Family Physician April 1, 2006 Barbara D. Reed	Vulvodynia: Diagnosis and Management The diagnosis of vulvodynia depends on a consistent history, lack of a documented infectious or dermatologic cause, and in most women, tenderness when gentle pressure is applied by a cotton swab to the vulva, introitus, or hymenal areas.
American Family Physician April 15, 2001	Dyspareunia: What it Might Mean for You Dyspareunia is painful sexual intercourse. It can have many causes. It is important to talk to your doctor if you have this problem because there are effective treatments for many of the causes...
American Family Physician April 15, 2002 Judy D. Bremnor	Evaluation of Dysuria in Adults Dysuria is the sensation of pain, burning, or discomfort on urination. Although many physicians equate dysuria with urinary tract infection , it is actually a symptom that has many potential causes. Empiric treatment with antibiotics may be inappropriate, except in carefully selected patients...
American Family Physician September 1, 2000	Diagnosis of Vaginitis Vaginitis is the most frequent gynecologic diagnosis encountered by physicians who provide primary care to women. Accurate diagnosis can be elusive, complicating treatment...
American Family Physician November 15, 2001 Edward R. Feller	Gynecologic Aspects of Crohn's Disease This article reviews the diverse gynecologic spectrum, protean manifestations and diagnostic difficulties of pelvic Crohn's disease...
American Family Physician February 15, 2001 Paul Nyirjesy	Chronic Vulvovaginal Candidiasis Frequently ignored by the medical community, chronic vulvovaginal symptoms are relatively common and can be frustrating for patients and physicians. Establishing a proper diagnosis will lay the foundation for an effective therapeutic plan...
American Family Physician October 1, 2001 Julius F. Metts	Interstitial Cystitis: Urgency and Frequency Syndrome Patients with irritative voiding symptoms and negative urine cultures frequently present a diagnostic challenge for primary care physicians. Interstitial cystitis is a chronic, severely debilitating disease of the urinary bladder...
American Family Physician August 2001 Saud Suleiman & David E. Johnston	The Abdominal Wall: An Overlooked Source of Pain When abdominal pain is chronic and unremitting, with minimal or no relationship to eating or bowel function but often a relationship to posture (i.e., lying, sitting, standing), the abdominal wall should be suspected as the source of pain...
Nurse Practitioner January 2011 Reimer & Johnson	Atrophic vaginitis signs, symptoms, and better outcomes This article reviews physiology, clinical manifestations, signs, symptoms, and treatment methods for atrophic vaginitis.
American Family Physician August 15, 2006 Mounsey, Wilgus & Slawson	Diagnosis and Management of Endometriosis The preferred method for diagnosis of endometriosis is surgical visual inspection of pelvic organs with histologic confirmation. Such diagnosis requires an experienced surgeon because the varied appearance of the disease allows less-obvious lesions to be overlooked.
American Family Physician January 15, 2003 Nusbaum et al.	Chronic Illness and Sexual Functioning Patients who have chronic illness often have difficulties with sexual functioning. With an understanding of the impact that illness can have on sexual functioning and the use of basic management strategies, family physicians can readily enhance quality of life for their patients.
American Family Physician March 1, 2001 Sheela L. Lahoti	Evaluating the Child for Sexual Abuse Because the examination findings of most child victims of sexual abuse are within normal limits or are nonspecific, the child's statements are extremely important...
American Family Physician November 1, 2002 Nusbaum & Hamilton	The Proactive Sexual Health History Physicians consistently underestimate the prevalence of sexual concerns in their patients. By allocating time to discuss sexual health during office visits, high-risk sexual behaviors that can cause STDs, unintended pregnancies, and unhealthy sexual decisions may be reduced.
American Family Physician October 1, 2002 Canavan & Cohen	Vulvar Cancer Vulvar cancer was reported in 3,200 women in 1998, resulting in 800 deaths. Recent evidence suggests that vulvar cancer comprises two separate diseases.
American Family Physician September 15, 2000 Toni Lapp	Practice Guidelines ACOG Issues Recommendations for the Management of Endometriosis
Nurse Practitioner Keyock & Newman	Understanding stress urinary incontinence Underreported and undertreated, stress urinary incontinence leads to decreased quality of life in sufferers and financial burdens for both the patient and the healthcare industry. Nurse practitioners should understand their role in identifying, diagnosing, and treating the condition.
American Family Physician March 1, 2006 Steven H. Crossman	The Challenge of Pelvic Inflammatory Disease Pelvic inflammatory disease (PID) is an infection of the upper genital tract in women that can include endometritis, parametritis, tubo-ovarian abscess, and peritonitis. The spectrum of disease ranges from subclinical, asymptomatic infection to severe, life-threatening illness.
American Family Physician July 1, 2000	Sex Isn't Working for Me. What Can I Do? When you have problems with sex, doctors call it "sexual dysfunction." Men and women can have it. There are four kinds of sexual problems in women.
American Family Physician July 1, 2006 Junnila & Cartwright	Chronic Musculoskeletal Pain in Children: Part I. Initial Evaluation Musculoskeletal pain can be difficult for children to characterize. A logical and consistent approach to diagnosis is recommended, with judicious use of laboratory and radiologic testing.
Health April 2007 Libby Slate	Pelvic Pain? Solve the Mystery Use this checklist to explore the possible reasons and remedies.
Nurse Practitioner May 2012 Hammersla & Kapustin	Peripheral Neuropathy: Evidence-based treatment of a complex disorder Peripheral neuropathy is a common and often progressive condition frequently seen in primary care. The chronic pain associated with PN, or neuropathic pain, can significantly diminish patients' quality of life and be challenging to treat.
Nursing September 2008 Susan Simmons Holcomb	Acute Abdomen: What a Pain! So many things - some life-threatening - can cause abdominal pain. Here's how to capture the clues quickly and accurately.
American Journal of Nursing December 2010 Baldridge & Andrasek	Pain Assessment in People with Intellectual or Developmental Disabilities Nurses in all settings need to be knowledgeable about alternate pain assessment methods.
American Family Physician July 15, 2004 Tracy Aldridge	Diagnosing Heel Pain in Adults A thorough history and a physical examination of the lower extremity should be conducted to locate the pain, define its attributes, and narrow the differential diagnosis.
Nurse Practitioner May 2009 Yvonne D'Arcy	Is Low Back Pain Getting on Your Nerves? The pain and disability of low back pain are the most common reasons patients seek healthcare. Here are tools for diagnosis and treatment options.
American Family Physician February 15, 2002 David J. Alvarez	Trigger Points: Diagnosis and Management Trigger points are discrete, focal, hyperirritable spots located in a taut band of skeletal muscle. They produce pain locally and in a referred pattern and often accompany chronic musculoskeletal disorders...
American Family Physician October 15, 2001 Vincent Morelli	Groin Injuries in Athletes Groin injuries comprise 2 to 5 percent of all sports injuries. Early diagnosis and proper treatment are important to prevent these injuries from becoming chronic and potentially career-limiting...
Nursing October 2009 Yvonne D'Arcy	Overturning barriers to pain relief in older adults This article will describe how to lower the barriers to effective pain control in older patients and provide practical tips for helping them receive the full benefit from pharmacologic and nonpharmacologic therapies.
Nursing Management March 2012 Yvonne D'Arcy	Pain and obesity It can be a challenge to provide effective pain management for obese patients; however, a multimodal pain management regimen that combines medications and complementary techniques can help increase pain relief.
American Journal of Nursing April 2010 Mary Curry Narayan	Culture's Effects on Pain Assessment and Management When patients belong to a culture or speak a language that's different from that of their health care provider, the provider faces additional challenges in successfully assessing and managing the patients' pain.
Nurse Practitioner December 2011	Managing pain in obese patients Obesity-related pain conditions can limit the patient's efforts at increasing activity and limit quality of life. This article will offer information on these conditions and treatment options.
American Journal of Nursing April 2009	Understanding and Managing Burn Pain: Part 1 Despite advances in topical wound care and pharmacology, and a growing emphasis on palliative care, wound care is the main source of the pain associated with burn injury.
American Family Physician November 1, 2006 Lyon & Clark	Diagnosis of Acute Abdominal Pain in Older Patients Acute abdominal pain is a common presenting complaint in older patients, but may be difficult to diagnose. Here are some common causes of abdominal pain in old patients and recommendations for treatment.
American Family Physician October 1, 2001 Karl E. Miller	Challenges in Pain Management at the End of Life Effective pain management in the terminally ill patient requires an understanding of pain control strategies. Ongoing assessment of pain is crucial and can be accomplished using various forms and scales...
Nursing June 2008 Yvonne D'arcy	Nursing2008 Pain Management Survey Report See how your responses to this survey compare with those of nursing colleagues across the country and beyond.
American Family Physician November 15, 2005 William E. Cayley	Diagnosing the Cause of Chest Pain Distinguishing between serious and benign causes of chest pain is imperative, and diagnostic and prognostic questions are important in making this determination.
American Journal of Nursing March 2011 Jablonski et al.	The Use of Algorithms in Assessing and Managing Persistent Pain in Older Adults This article introduces readers to the use of algorithms in guiding the assessment and management of persistent pain in older adults, and provides an illustrative case study.
American Journal of Nursing May 2009 Patricia Connor-Ballard	Understanding and Managing Burn Pain: Part 2 Despite advances in treatment of burn injuries and their consequent pain, wound care is the main source of the pain associated with burn injury.
American Family Physician May 15, 2001 Allan Gottschalk & David S. Smith	New Concepts in Acute Pain Therapy: Preemptive Analgesia Preemptive analgesia, an evolving clinical concept, involves the introduction of an analgesic regimen before the onset of noxious stimuli, with the goal of preventing sensitization of the nervous system to subsequent stimuli that could amplify pain...
Managed Care May 2005	Microcircuit Devices Deliver Considerable Relief From Chronic Pain Recent advances in pain relief revolve around longer-lasting implantable devices. Can managed care afford not to have a pain management strategy?
American Journal of Nursing July 2008 Horgas & Miller	Pain Assessment in People with Dementia The Pain Assessment in Advanced Dementia (PAINAD) scale has been designed to assess pain in this population by looking at five specific indicators.
HHMI Bulletin February 2012 Marc Wortman	Where Does It Hurt? Researchers are getting to the molecular details of pain's circuitry to answer the question with real specificity.
American Family Physician February 1, 2005 Maizels & McCarberg	Antidepressants and Antiepileptic Drugs for Chronic Non-Cancer Pain The development of newer classes of antidepressants and second-generation antiepileptic drugs has created unprecedented opportunities for the treatment of chronic pain. These drugs modulate pain transmission by interacting with specific neurotransmitters and ion channels.
American Journal of Nursing June 2008 Ellen Flaherty	How to Try This: Using Pain-Rating Scales with Older Adults Pain is often undertreated and underdiagnosed in older adults. Regular use of short, simple, reliable pain-rating scales provides nurses and physicians with measurable information to establish and modify a pain management plan.
American Family Physician August 15, 2006	Endometriosis: What You Should Know A patient guide: What is endometriosis?... How do I know if I have endometriosis?... How is it treated?... What do these medicines do?... Can I still get pregnant?... etc.
Salon.com October 26, 2000 Barbara Raab	The vagina dialogues Hundreds of doctors gather in Boston for their annual gabfest about women's sexual dysfunction -- but some of their colleagues say they're misguided...
Salon.com March 6, 2000 Michael Alvear	Is it all in your head? Yes, but that doesn't make the pain any less real.
American Family Physician December 1, 2000	Letters to the Editor Osteopathic Medicine in the Treatment of Low Back Pain...