Chronic Pelvic Pain in Women

Updated: Jan 13, 2015
  • Author: Manish K Singh, MD; Chief Editor: Michel E Rivlin, MD  more...
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Overview

Background

Chronic pelvic pain (CPP) is a common problem and presents a major challenge to health care providers because of its unclear etiology, complex natural history, and poor response to therapy.

Chronic pelvic pain is poorly understood and, consequently, poorly managed. This condition is best managed using a multidisciplinary approach. Management requires good integration and knowledge of all pelvic organ systems and other systems including musculoskeletal, neurologic, and psychiatric systems.

A significant number of these patients may have various associated problems, including bladder or bowel dysfunction, sexual dysfunction, and other systemic or constitutional symptoms. Other associated problems, such as depression, anxiety, and drug addiction, may also coexist.

In the United States, estimated direct medical costs for outpatient visits for chronic pelvic pain (women aged 18-50 y) is approximately $881.5 million per year. [1]

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Pathophysiology

The pathophysiology of chronic pelvic pain is complex and multifactorial. It remains unclear.

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Epidemiology

Frequency

United States

Chronic pelvic pain is a common problem. It affects approximately 1 in 7 women. [1] In one study of reproductive-aged women in primary care practices, the reported prevalence rate of pelvic pain was 39%. [2] Of all referrals to gynecologists, 10% are for pelvic pain. [3]

International

A similar prevalence of chronic pelvic pain has been described in other countries. [4]

Mortality/Morbidity

As with other chronic pain, chronic pelvic pain may lead to prolonged suffering, marital and family problems, loss of employment or disability, and various adverse medical reactions from lifelong therapy.

Complications

Like other chronic pain, chronic pelvic pain may lead to prolonged suffering, marital or family problems, loss of employment, disability, and various adverse medical reactions from lifelong therapy.

Race

In one study, blacks had a higher incidence of pelvic pain. [2]

Sex

Chronic pelvic pain is most common among reproductive-aged women. Common causes of chronic pelvic pain in men include chronic (nonbacterial) prostatitis, chronic orchalgia, and prostatodynia.

Age

Chronic pelvic pain is most common among reproductive-aged women, especially those aged 26-30 years. [2]

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