Chronic pelvic pain: A case for an interdisciplinary evaluation and treatment approach

Chronic pelvic pain is a common problem for women, being the single most common reason for referral to a gynecologist, with an estimated prevalence of 38 per 1,000 women. Over $881 million is spent annually in the USA managing chronic pelvic pain on an outpatient basis. It is a common disabling condition whose causes and treatments are poorly understood. Many women as well as health care providers get frustrated with the all-too-often lack of relief after many interventions and attempts at pharmacological treatments. It can have a devastating effect on a woman's sexuality and her relationship with her partner. It is commonly recognized that psychological issues play an important role in the origin and treatment of this condition. A recent extensive systematic review of the literature regarding factors predisposing women to chronic pelvic pain concluded that both gynecological and psychosocial factors are strongly associated with chronic pelvic pain. This would appear to mandate a comprehensive collaborative medical and psychological approach to the evaluation and treatment of women suffering with pelvic pain. The objective of this paper is to demonstrate the utility and mechanisms of this approach.