Chronic pelvic pain in women

Abstract

Chronic pelvic pain in women is commonly seen in general practice. Chronic pain is usually defined as the continuation of pain for more than 3 to 6 months, and it may have more than one cause. Pelvic pain is defined as pain in the lower abdomen or within the pelvis. Chronic pelvic pain may include dysmenorrhoea, dyspareunia, dysuria and pain on passing a stool (dyschesia), but can occur without any of these symptoms. Managing chronic pelvic pain can seem daunting, but it is appropriate to assess, investigate and manage this problem in primary care. This article provides a framework for history, examination and initial investigation of chronic pelvic pain in primary care. However, more complex cases may require a multidisciplinary approach, with referral to secondary care services such as a pain clinic, urology or gynaecology.