Chronic pelvic pain - Part 1: Prevalence, evaluation, etiology, and comorbidities

Lee A. Learman

Research output: Contribution to journalReview article

5 Scopus citations


PURPOSE: To discuss the prevalence, etiology, and evaluation of patients presenting with chronic pelvic pain (CPP); clinical management of this condition and/or its underlying causes will be discussed in Part 2 of this series. EPIDEMIOLOGY: Though estimates vary, CPP is believed to affect at least 4% and in some studies as many as 40% of women who seek primary care, making this symptom at least as common as asthma and back pain. CPP is responsible for 10% of all referrals to gynecologists, 12% of all hysterectomies, and more than 40% of all laparoscopies. REVIEW SUMMARY: CPP in women is a condition that substantially affects quality of life and has an economic impact approaching US $2 billion annually. For the clinician, CPP represents a formidable diagnostic challenge because ifs underlying etiology may be multifaceted, including not only gynecologic but also gastrointestinal, urologic, and neuropsychiatric systems. The differential diagnosis can be complex, and a thorough history and physical examination are essential to proper diagnosis ana treatment. Though organic causes (most commonly endometriosis, irritable bowel syndrome, and interstitial cystitis) often underlie this condition, muscular maladaptations and emotional factors, such as depression, are common comorbidities. TYPE OF AVAILABLE EVIDENCE: Systematic reviews, randomized-controlled trials, national treatment guidelines. GRADE OF AVAILABLE EVIDENCE: Fair. CONCLUSION: Chronic pelvic pain is a prevalent problem among women, and thus is physically, socially, and financially burdensome for individuals as well as society. Multiple etiologies and associations with conditions arising from several organ systems may be responsible, necessitating extensive evaluation and making a multidisciplinary approach to the problem paramount to determining a treatment plan-the details of which will be addressed in Part 2 of this series.

Original languageEnglish (US)
Pages (from-to)306-315
Number of pages10
JournalAdvanced Studies in Medicine
Issue number6
StatePublished - Jun 1 2005

ASJC Scopus subject areas

  • Medicine(all)

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