REVIEW – January 2008

Chronic pelvic pain: epidemiology and risk factors

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Abstract

Chronic pelvic pain (CPP) is a common condition in women that is hard to diagnose. The epidemiology of CPP is very difficult to investigate because of: 1) lack of consensus regarding its clinical definition across studies; 2) its multi-causal origin; and 3) study design complications. Using the most common definition of CPP (lower abdominal pain of at least 6 month`s duration, excluding pain solely related to pregnancy, menstruation, or intercourse), the prevalence of CPP among women of reproductive age in general population is estimated to be as high as 25%. Investigation of the aetiology of CPP  through assessment of “risk factors” remains highly complicated because of the complexity of the condition. Half the women with chronic pelvic pain also have either genitourinary or irritable bowel syndrome, or both. Prevalence of dysmenorrhea and dyspareunia is higher among women with CPP than among women without chronic pelvic pain. Irritable bowel syndrome and stress were the most common diagnoses received by patients with chronic pelvic pain, but in 50% the diagnosis was never made.