Chronic Pelvic Pain: Prevalence, Health-Related Quality of Life, and Economic Correlates
Abstract
OBJECTIVE: To determine the prevalence of chronic pelvic pain in U.S. women aged 18-50 years, and to examine its association with health-related quality of life, work productivity, and health care utilization. METHODS: In April and May 1994, the Gallup Organization telephoned 17,927 U.S. households to identify women aged 18-50 years who experienced chronic pelvic pain, ie, of at least 6 months' duration. Those who reported chronic pelvic pain were surveyed on severity, frequency, and diagnosis; quality of life; work loss and productivity; and health care utilization. RESULTS: Among 5263 eligible women who agreed to participate, 773 (14.7%) reported chronic pelvic pain within the past 3 months. Those who reported chronic pelvic pain had significantly lower mean scores for general health than those who did not (70.5 versus 78.8,P<.05), and 61% of those with chronic pelvic pain reported that the etiology was unknown. Women diagnosed with endometriosis reported the most health distress, pain during or after intercourse, and interference with activities because of pain. Estimated direct medical costs for outpatient visits for chronic pelvic pain for the U.S population of women aged 18-50 years are $881.5 million per year. Among 548 employed respondents, 15% reported time lost from paid work and 45% reported reduced work productivity. CONCLUSION: Frequently, the cause of chronic pain is undiagnosed, although it affects approximately one in seven U.S. women. Increased awareness of its cost and impact on quality of life should promote increased medical attention to this problem.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Endometriosis is a more costly public health problem than migraine and Crohn's disease in women, due to high rates of hospital admissions, surgical procedures, and comorbid conditions.
“The high rates of hospital admissions, surgical procedures, and incidence of comorbid conditions make endometriosis a more costly public health problem than commonly known medical conditions in women such as migraine and Crohn’s disease (13-17).”
From Patients’ report on how endometriosis affects health, work, and daily life (2010) · cites this paper as [16]
Cites
Statistical Abstract of the U nited S tates
(2005) · Wiley eBooks · doi:10.1002/0471667196.ess2527 · Cited by 8,872 · see citing works
Measuring Functioning and Well-Being: The Medical Outcomes Study Approach
Stewart, A., & Ware, J. (1992) · doi:10.7249/cb361 · Cited by 2,689 · see citing works
Dicker, R. C., Greenspan, J., Strauss, L. T., Cowart, M. R., Scally, M. J., Peterson, H. B., Destefano, F. R., RUBIN, G. L., & Ory, H. W. (1982) · American Journal of Obstetrics and Gynecology · doi:10.1016/0002-9378(82)90362-3 · Cited by 749 · see citing works
Conceptualization and Measurement of Health for Adults in the Health Insurance Study
Stewart, A., Ware, J. E., Brook, R. H., & Davies, A. R. (1978) · Cited by 641 · see citing works
Jamieson, D. J., & Steege, J. F. (1996) · Obstetrics and Gynecology · doi:10.1016/0029-7844(95)00360-6 · Cited by 439 · see citing works
Relationship of chronic pelvic pain to psychiatric diagnoses and childhood sexual abuse
Walker, E., Katon, W. J., Harrop-Griffiths, J., Holm, L., Russo, J. E., & Hickok, L. R. (1988) · American Journal of Psychiatry · doi:10.1176/ajp.145.1.75 · Cited by 407 · see citing works
Prevalence and genesis of endometriosis
Mahmood, T. A., & Templeton, A. (1991) · Human Reproduction · doi:10.1093/oxfordjournals.humrep.a137377 · Cited by 367 · see citing works
Health Status, Quality of Life, and the Individual
Guyatt, G. H. (1994) · JAMA · doi:10.1001/jama.1994.03520080072047 · Cited by 231 · see citing works
Laparoscopy in 100 women with chronic pelvic pain.
Kresch, A. J., Seifer, D. B., Sachs, L. B., & Barrese, I. (1984) · PubMed · Cited by 231 · see citing works
A randomized clinical trial to compare two different approaches in women with chronic pelvic pain
Peters, A., van Dorst, E. B. L., Jellis, B., van Dorst, E. B. L., Hermans, J. H., & Trimbos, J. (1992) · International Journal of Gynecology & Obstetrics · doi:10.1016/0020-7292(92)90764-a · Cited by 217 · see citing works
Abuse history and chronic pain in women: I. Prevalences of sexual abuse and physical abuse
Walling, M. K., Reiter, R. C., O'Hara, M., Milburn, A., Lilly, G., & Vincent, S. D. (1995) · International Journal of Gynecology & Obstetrics · doi:10.1016/0020-7292(95)90235-x · Cited by 210 · see citing works
Confirmation of the preoperative diagnoses for hysterectomy
Lee, N. C., Dicker, R. C., RUBIN, G. L., & Ory, H. W. (1984) · American Journal of Obstetrics and Gynecology · doi:10.1016/s0002-9378(84)90366-1 · Cited by 172 · see citing works
A profile of women with chronic pelvic pain.
Reiter, R. C. (1990) · PubMed · Cited by 172 · see citing works
Nongynecologic somatic pathology in women with chronic pelvic pain and negative laparoscopy.
Rc, R., & Jc, G. (1991) · PubMed · Cited by 80 · see citing works
Steege, J. F., Stout, A. L., & Somkuti, S. G. (1993) · Obstetrical & Gynecological Survey · doi:10.1097/00006254-199302000-00014 · Cited by 73 · see citing works
The economic burden of intractable gynaecological pain
Davies, L. M., GANGAR, K. F., Drummond, M., Saunders, D., & Beard, R. W. (1992) · Journal of Obstetrics and Gynaecology · doi:10.3109/01443619209045615 · Cited by 55 · see citing works
ENDOMETRIOSIS AND CHRONIC PELVIC PAIN
Ripps, B. A., & Martin, D. C. (1993) · Obstetrics and Gynecology Clinics of North America · doi:10.1016/s0889-8545(21)00388-0 · Cited by 31 · see citing works
Nolan, T. E., & Elkins, T. E. (1993) · Postgraduate Medicine · doi:10.1080/00325481.1993.11945774 · Cited by 20 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Eskenazi, B., & Warner, M. L. (1997) · Obstetrics and Gynecology Clinics of North America · doi:10.1016/s0889-8545(05)70302-8 · Cited by 1,617 · see citing works
Nnoaham, K. E., Hummelshoj, L., Webster, P., d’Hooghe, T., de Cicco Nardone, F., de Cicco Nardone, C., Jenkinson, C., Kennedy, S. H., & Zondervan, K. T. (2011) · Fertility and Sterility · doi:10.1016/j.fertnstert.2011.05.090 · Cited by 1,584 · see citing works
“) (14, 15), but those studies only considered absenteeism.”
BackgroundThe unequal burden of pain: confronting racial and ethnic disparities in pain
Green, C. R., Anderson, K. O., Baker, T. A., Campbell, L. C., Decker, S., Fillingim, R. B., Kaloukalani, D. A., Lasch, K. E., Myers, C., Tait, R. C., et al. (2003) · Pain Medicine · doi:10.1046/j.1526-4637.2003.03034.x · Cited by 1,248 · see citing works
Latthe, P. M., Latthe, M., Say, L., Gülmezoglu, M., & Khan, K. S. (2006) · BMC Public Health · doi:10.1186/1471-2458-6-177 · Cited by 764 · see citing works
Bannister, S. J. (2009) · Cited by 749 · see citing works
The social and psychological impact of endometriosis on women's lives: a critical narrative review
Culley, L. A., Law, C., Hudson, N., Denny, E., Mitchell, H., Baumgarten, M. N., & Raine‐Fenning, N. (2013) · Human Reproduction Update · doi:10.1093/humupd/dmt027 · Cited by 689 · see citing works
“However, Fourquet et al. (2010) also found that only 47% of women who had difficulties conceiving sought infertility treatment and Mathias et al. (1996) found that only 4% of women were undergoing infertility treatment.”
BackgroundResultBallard, K., Lowton, K., & Wright, J. (2006) · Fertility and Sterility · doi:10.1016/j.fertnstert.2006.04.054 · Cited by 628 · see citing works
Sinaii, N. (2002) · Human Reproduction · doi:10.1093/humrep/17.10.2715 · Cited by 620 · see citing works
“%) reported pain ascribed to endometriosis, and 96% had pain during menses (Table III), which is higher than the 13–15% rate for dysmenorrhoea in the general population (Mathias et al., 1996; Campbell et al., 1997).”
BackgroundFactors predisposing women to chronic pelvic pain: systematic review
Latthe, P. M., Mignini, L. E., Gray, R. G., Hills, R. K., & Khan, K. S. (2006) · BMJ · doi:10.1136/bmj.38748.697465.55 · Cited by 582 · see citing works
Endometriosis and pelvic pain: epidemiological evidence of the relationship and implications
Fauconnier, A., & Chapron, C. (2005) · Human Reproduction Update · doi:10.1093/humupd/dmi029 · Cited by 522 · see citing works
“Some authors use a restrictive definition, excluding severe dysmenorrhoea and deep dyspareunia (Howard, 1994; Kontoravdis et al., 1996; Mathias et al., 1996; Zondervan et al., 2001; Jones and Sutton, 2003).”
BackgroundRelation between pain symptoms and the anatomic location of deep infiltrating endometriosis
Fauconnier, A., Chapron, C., Dubuisson, J.-B., Vieira, M., Dousset, B., & Bréart, G. (2002) · Fertility and Sterility · doi:10.1016/s0015-0282(02)03331-9 · Cited by 498 · see citing works
Howard, F. M. (2003) · Obstetrics and Gynecology · doi:10.1016/s0029-7844(02)02723-0 · Cited by 487 · see citing works
De Graaff, A. A., D'Hooghe, T. M., Dunselman, G. A. J., Dirksen, C. D., Hummelshoj, L., WERF EndoCost Consortium, Simoens, S., Bokor, A., Brandes, I., Brodszky, V., et al. (2013) · Human Reproduction · doi:10.1093/humrep/det284 · Cited by 473 · see citing works
Manchikanti, L. (2008) · Pain Physician · doi:10.36076/ppj.2008/11/s5 · Cited by 430 · see citing works
Lamvu, G., Carrillo, J. F., Ouyang, C., & Rapkin, A. J. (2021) · JAMA · doi:10.1001/jama.2021.2631 · Cited by 392 · see citing works
Endometriosis: cost estimates and methodological perspective
Simoens, S., Hummelshoj, L., & D'Hooghe, T. (2007) · Human Reproduction Update · doi:10.1093/humupd/dmm010 · Cited by 357 · see citing works
“Thirteen studies met our inclusion criteria: four cost-of-illness analyses of endometriosis (Kunz et al., 1995; Mathias et al., 1996; Zhao et al., 1998a; Gao et al., 2006), two cost analyses of endometriosis (Zhao et al.”
BackgroundMethodInfluentialDiagnostic experience among 4,334 women reporting surgically diagnosed endometriosis
Greene, R., Stratton, P., Cleary, S. D., Ballweg, M. L., & Sinaii, N. (2009) · Fertility and Sterility · doi:10.1016/j.fertnstert.2007.11.020 · Cited by 327 · see citing works
Zondervan, K. T., Yudkin, P. L., Vessey, M. P., Dawes, M. G., Barlow, D. H., & Kennedy, S. (1999) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.1999.tb08140.x · Cited by 321 · see citing works
The community prevalence of chronic pelvic pain in women and associated illness behaviour.
Zondervan, K. T., Yudkin, P. L., Vessey, M. P., Jenkinson, C., Dawes, M. G., Barlow, D. H., & Kennedy, S. H. (2001) · Europe PMC (PubMed Central) · Cited by 303 · see citing works
Pezzone, M. A., Liang, R., & Fraser, M. O. (2005) · Gastroenterology · doi:10.1053/j.gastro.2005.03.008 · Cited by 292 · see citing works
Economic burden of endometriosis
Gao, X., Outley, J., Botteman, M., Spalding, J., Simon, J. A., & Pashos, C. L. (2006) · Fertility and Sterility · doi:10.1016/j.fertnstert.2006.06.015 · Cited by 289 · see citing works
Akobundu, E., Ju, J., Blatt, L., & Mullins, C. D. (2006) · PharmacoEconomics · doi:10.2165/00019053-200624090-00005 · Cited by 283 · see citing works
Arnold, L. D., Bachmann, G. A., Rosen, R. C., Kelly, S., & Rhoads, G. G. (2006) · Obstetrics and Gynecology · doi:10.1097/01.aog.0000199951.26822.27 · Cited by 277 · see citing works
Chronic pelvic pain in the community—Symptoms, investigations, and diagnoses
Zondervan, K. T., Yudkin, P. L., Vessey, M. P., Jenkinson, C., Dawes, M. G., Barlow, D. H., & Kennedy, S. (2001) · American Journal of Obstetrics and Gynecology · doi:10.1067/mob.2001.112904 · Cited by 276 · see citing works
Central changes associated with chronic pelvic pain and endometriosis
Brawn, J., Morotti, M., Zondervan, K. T., Becker, C. M., & Vincent, K. (2014) · Human Reproduction Update · doi:10.1093/humupd/dmu025 · Cited by 274 · see citing works
“, 1999a, b), with a significant financial cost to both the individual and society (Mathias et al., 1996), there is frequently a significant delay in diagnosis and treatment.”
As-Sanie, S., Harris, R. E., Napadow, V., Kim, J., Neshewat, G., Kairys, A., Williams, D., Clauw, D. J., & Schmidt-Wilcke, T. (2012) · Pain · doi:10.1016/j.pain.2012.01.032 · Cited by 268 · see citing works
“CPP is estimated to affect 15-20% of women in the United States, with direct health-care costs approaching $2.8 billion dollars per year[3;23].”
InfluentialPatients’ report on how endometriosis affects health, work, and daily life
Fourquet, J., Gao, X., Zavala, D., Orengo, J. C., Abac, S., Ruiz, A., Laboy, J., & Flores, I. (2010) · Fertility and Sterility · doi:10.1016/j.fertnstert.2009.09.017 · Cited by 252 · see citing works
“The high rates of hospital admissions, surgical procedures, and incidence of comorbid conditions make endometriosis a more costly public health problem than commonly known medical conditions in women such as migraine and Crohn’s disease (13-17).”
Botulinum Toxin Type A for Chronic Pain and Pelvic Floor Spasm in Women
Abbott, J. A., Jarvis, S. K., Lyons, S. D., Thomson, A. J. M., & Vancaille, T. G. (2006) · Obstetrics and Gynecology · doi:10.1097/01.aog.0000237100.29870.cc · Cited by 253 · see citing works
Progestagens and anti-progestagens for pain associated with endometriosis
Brown, J., Kives, S., & Akhtar, M. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002122.pub2 · Cited by 250 · see citing works
Risk Factors for Chronic Pain after Hysterectomy
Brandsborg, B., Nikolajsen, L., Hansen, C. T., Kehlet, H., & Jensen, T. S. (2007) · Anesthesiology · doi:10.1097/01.anes.0000265161.39932.e8 · Cited by 245 · see citing works
“Other studies of hysterectomy have found pain frequencies that vary from 4.7% to 26.2% in long-term follow-up, but details are lacking regarding pain frequency, intensity, and location.4–10 Pelvic pain is a frequent symptom in fertile women, and posthysterectomy pain may reflect pain in a normal population.13 The 3-mo…”
BackgroundInfluentialPelvic floor physical therapy in the treatment of pelvic floor dysfunction in women
Wallace, S. L., Miller, L., & Mishra, K. (2019) · Current Opinion in Obstetrics & Gynecology · doi:10.1097/gco.0000000000000584 · Cited by 284 · see citing works
Ling, F. (1999) · Obstetrics & Gynecology · doi:10.1016/s0029-7844(98)00341-x · Cited by 222 · see citing works
Epidemiology of pain and relation to psychiatric disorders
Velly, A. M., & Mohit, S. (2017) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2017.05.012 · Cited by 223 · see citing works
“Further, the prevalence of chronic pelvic pain among women ranges from 11% to 25% (Mathias et al., 1996; Coelho et al., 2014; Grace and Zondervan, 2004), and among men from 2% to 10% (Clemens et al.”
A life shaped by pain: women and endometriosis
Huntington, A., & Gilmour, J. A. (2005) · Journal of Clinical Nursing · doi:10.1111/j.1365-2702.2005.01231.x · Cited by 208 · see citing works
Tripoli, T. M., Sato, H., Sartori, M. G., de Araujo, F. F., Girão, M. J. B. C., & Schor, E. (2011) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2010.01976.x · Cited by 209 · see citing works
The search for genes contributing to endometriosis risk
Montgomery, G. W., Nyholt, D. R., Zhao, Z. Z., Treloar, S. A., Painter, J. N., Missmer, S. A., Kennedy, S. H., & Zondervan, K. T. (2008) · Human Reproduction Update · doi:10.1093/humupd/dmn016 · Cited by 211 · see citing works
“The disorder often recurs and has a major impact on women’s health, relationships, productivity and life choices (Mathias et al., 1996; Simoens et al., 2007).”
BackgroundHealth-related quality of life burden of women with endometriosis: a literature review
Gao, X., Yeh, Y.-C., Outley, J., Simon, J., Botteman, M., & Spalding, J. (2006) · Current Medical Research and Opinion · doi:10.1185/030079906x121084 · Cited by 206 · see citing works
The link between immunity, autoimmunity and endometriosis: a literature update
Zhang, T., De Carolis, C., Man, G. C. W., & Wang, C. C. (2018) · Autoimmunity Reviews · doi:10.1016/j.autrev.2018.03.017 · Cited by 196 · see citing works
Convergence of bladder and colon sensory innervation occurs at the primary afferent level
Christianson, J. A., Liang, R., Ustinova, E. E., Davis, B. M., Fraser, M. O., & Pezzone, M. A. (2006) · Pain · doi:10.1016/j.pain.2006.09.023 · Cited by 194 · see citing works
“CPP affects 15% of both men and women, and commonly involves the pelvic cavity, as in irritable bowel syndrome (IBS) and interstitial cystitis (IC), and/or the pelvic floor (Mathias et al., 1996; Berger et al., 1998; Wesselmann, 2001; Zondervan et al., 2001; Moldwin, 2002; Clemens et al., 2005).”
BackgroundIntegrated behavioral health in primary care: Step-by-step guidance for assessment and intervention.
Hunter, C. L., Goodie, J. L., Oordt, M. S., & Dobmeyer, A. C. (2016) · American Psychological Association eBooks · doi:10.1037/0000017-000 · Cited by 191 · see citing works
Arnold, L. D., Bachmann, G. A., Rosen, R., & Rhoads, G. G. (2007) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2006.07.047 · Cited by 185 · see citing works
“Chronic fatigue 13/100 (13) 16/323 (5) 2.”
Norman, S. A., Lumley, M. A., Dooley, J. A., & Diamond, M. P. (2004) · Psychosomatic Medicine · doi:10.1097/01.psy.0000116979.77753.74 · Cited by 185 · see citing works
Sacral nerve stimulation in patients with chronic, intractable pelvic pain
Paszkiewicz, E., SIEGEL, S. W., Kirkpatrick, C., HINKEL, B., Keeisha, J., & Kirkemo, A. (2001) · Urology · doi:10.1016/s0090-4295(01)01080-9 · Cited by 179 · see citing works
Peng, P. (2008) · Pain Physician · doi:10.36076/ppj.2008/11/215 · Cited by 174 · see citing works
Multifactorial contributors to the severity of chronic pelvic pain in women
Yosef, A. H., Allaire, C., Williams, C., Ahmed, A. G. M., Al-Hussaini, T. K., Abdellah, M. S., Wong, F., Lisonkova, S., & Yong, P. J. (2016) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2016.07.023 · Cited by 173 · see citing works
Gonadotrophin-releasing hormone analogues for pain associated with endometriosis
Veth, V. B., van de Kar, M. M., McDonnell, R., Julania, S., & Hart, R. J. (2010) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008475.pub2 · Cited by 182 · see citing works
Zhang, T., Liang, H., Wang, Z., Qiu, C., Peng, Y. B., Zhu, X., Li, J., Ge, X., Xu, J., Huang, X. L., et al. (2022) · Science Advances · doi:10.1126/sciadv.abk0159 · Cited by 168 · see citing works
Interventions for treating chronic pelvic pain in women
Stones, W., Cheong, Y. C., Howard, F. M., & Singh, S. (2003) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd000387 · Cited by 165 · see citing works
RetractedCesarean section as a cause of chronic pelvic pain
Almeida, E. C. S., Nogueira, A. A., dos Reis, F. J. C., & Silva, J. C. R. E. (2002) · International Journal of Gynecology & Obstetrics · doi:10.1016/s0020-7292(02)00227-8 · Cited by 164 · see citing works
Grace, V. M., & Zondervan, K. T. (2004) · Australian and New Zealand Journal of Public Health · doi:10.1111/j.1467-842x.2004.tb00446.x · Cited by 164 · see citing works
Okaro, E., Condous, G. S., Khalid, A., Timmerman, D., Ameye, L., Huffel, S., & Bourne, T. (2006) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2006.00849.x · Cited by 163 · see citing works
CT and MRI of Pelvic Varices in Women
Coakley, F. V., Varghese, S. L., & Hricak, H. (1999) · Journal of Computer Assisted Tomography · doi:10.1097/00004728-199905000-00018 · Cited by 162 · see citing works
Jones, G. L., Kennedy, S., & Jenkinson, C. (2002) · American Journal of Obstetrics and Gynecology · doi:10.1067/mob.2002.124940 · Cited by 161 · see citing works
The Effect of Endometriosis Symptoms on Absenteeism and Presenteeism in the Workplace and at Home
Soliman, A. M., Coyne, K. S., Gries, K. S., Castelli‐Haley, J., Snabes, M. C., & Surrey, E. S. (2017) · Journal of Managed Care & Specialty Pharmacy · doi:10.18553/jmcp.2017.23.7.745 · Cited by 160 · see citing works
Pelvic Pain: Overlooked and Underdiagnosed Gynecologic Conditions
Kuligowska, E., Deeds, L., & Lu, K. (2005) · Radiographics · doi:10.1148/rg.251045511 · Cited by 159 · see citing works
Dienogest in long-term treatment of endometriosis
Schindler, A. E. (2011) · International Journal of Women s Health · doi:10.2147/ijwh.s5633 · Cited by 162 · see citing works
SACRAL NERVE STIMULATION IN PATIENTS WITH CHRONIC INTRACTABLE PELVIC PAIN
SIEGEL, S. W., PASZKIEWICZ, E., KIRKPATRICK, C., HINKEL, B., & OLESON, K. A. (2001) · The Journal of Urology · doi:10.1016/s0022-5347(05)65665-0 · Cited by 158 · see citing works
Harel, Z. (2012) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.2012.725045 · Cited by 155 · see citing works
“It has been estimated that 15% of young adult women suffer from chronic pelvic pain, with up to 97% of these women having endometriosis [3].”
BackgroundNon-surgical interventions for the management of chronic pelvic pain
Cheong, Y. C., Smotra, G., & Williams, A. C. D. C. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008797.pub2 · Cited by 152 · see citing works
Jarvis, S. K., Abbott, J. A., Lenart, M., Steensma, A. B., & Vancaillie, T. G. (2004) · Australian and New Zealand Journal of Obstetrics and Gynaecology · doi:10.1111/j.1479-828x.2004.00163.x · Cited by 152 · see citing works
Mental health and primary dysmenorrhea: a systematic review
Bajalan, Z., Moafi, F., MoradiBaglooei, M., & Alimoradi, Z. (2018) · Journal of Psychosomatic Obstetrics & Gynecology · doi:10.1080/0167482x.2018.1470619 · Cited by 155 · see citing works
“Dysmenorrhea is one of the conditions that causes chronic pelvic pain and has significant physical, emotional and economic effects on individuals’ health [54].”
BackgroundDmowski, W. P., Lesniewicz, R., Rana, N., Pepping, P., & Noursalehi, M. (1997) · Fertility and Sterility · doi:10.1016/s0015-0282(97)81904-8 · Cited by 151 · see citing works
Clemens, J. Q., Link, C. L., Eggers, P. W., Kusek, J. W., Nyberg, L. M., McKinlay, J. B., & BACH Survey Investigators (2007) · The Journal of Urology · doi:10.1016/j.juro.2006.11.084 · Cited by 149 · see citing works
Romão, A., Gorayeb, R. P., Romão, G. S., Poli‐Neto, O. B., dos Reis, F. J. C., Rosa-e-Silva, J. C., & Nogueira, A. A. (2009) · International Journal of Clinical Practice · doi:10.1111/j.1742-1241.2009.02034.x · Cited by 146 · see citing works
RETIRED: Consensus Guidelines for the Management of Chronic Pelvic Pain
Jarrell, J. F., Vilos, G. A., Allaire, C., Burgess, S., Fortin, C. A., Gerwin, R. D., Lapensée, L., Lea, R. H., Leyland, N. A., Martyn, P., et al. (2005) · Journal of Obstetrics and Gynaecology Canada · doi:10.1016/s1701-2163(16)30993-8 · Cited by 148 · see citing works
More than just menstrual cramps: symptoms and uncertainty among women with endometriosis
Lemaire, G. S. (2004) · Journal of Obstetric, Gynecologic & Neonatal Nursing · doi:10.1177/0884217503261085 · Cited by 143 · see citing works
Chapron, C., Lafay-Pillet, M.-C., Monceau, É., Borghese, B., Ngô, C., de Souza, C. A. B., & de Ziegler, D. (2010) · Fertility and Sterility · doi:10.1016/j.fertnstert.2010.10.027 · Cited by 145 · see citing works
Trauma and Posttraumatic Stress Disorder in Women With Chronic Pelvic Pain
Meltzer-Brody, S. E., Leserman, J., Zolnoun, D., Steege, J. F., Green, E., & Teich, A. (2007) · Obstetrics and Gynecology · doi:10.1097/01.aog.0000258296.35538.88 · Cited by 143 · see citing works
DANIELS, J. P. (2009) · JAMA · doi:10.1001/jama.2009.1268 · Cited by 142 · see citing works
“Treatments for chronic pelvic pain are often unsatisfactory.(7) As part of the evaluation and management phase, patients often undergo diagnostic laparoscopy(8) but actionable pathology is found only occasionally.”
BackgroundPrevalence of Common Chronic Pain in Hong Kong Adults
Ng, K. F. J., Tsui, S. L., & Chan, W. S. (2002) · Clinical Journal of Pain · doi:10.1097/00002508-200209000-00001 · Cited by 138 · see citing works
Ustinova, E. E., Fraser, M. O., & Pezzone, M. A. (2006) · American Journal of Physiology-Renal Physiology · doi:10.1152/ajprenal.00395.2005 · Cited by 137 · see citing works
Systematic review of quality of life measures in patients with endometriosis
Bourdel, N., Chauvet, P., Billone, V., Douridas, G., Fauconnier, A., Gerbaud, L., & Canis, M. J. (2019) · PLoS ONE · doi:10.1371/journal.pone.0208464 · Cited by 139 · see citing works
Increased Pressure Pain Sensitivity in Women With Chronic Pelvic Pain
As‐Sanie, S., Harris, R. E., Harte, S. E., Tu, F. F., Neshewat, G. M., & Clauw, D. J. (2013) · Obstetrics and Gynecology · doi:10.1097/aog.0b013e3182a7e1f5 · Cited by 134 · see citing works
Psychology of Chronic Pelvic Pain: Prevalence, Neurobiological Vulnerabilities, and Treatment
TILL, S. R., AS-SANIE, S., & SCHREPF, A. (2019) · Clinical Obstetrics & Gynecology · doi:10.1097/grf.0000000000000412 · Cited by 134 · see citing works
Wesselmann, U., & Lai, J. (1997) · Pain · doi:10.1016/s0304-3959(97)00112-7 · Cited by 131 · see citing works
“Surprisingly little is known about the pathways and mediators of pain from the female reproductive organs, despite the wide variety of acute and chronic pain disorders arising from the female reproductive tract (Rapkin, 1995; Mathias et al., 1996; Wesselmann, 1997a).”
BackgroundEvaluation and Management of Women With Endometriosis
Winkel, C. A. (2003) · Obstetrics and Gynecology · doi:10.1016/s0029-7844(03)00474-5 · Cited by 129 · see citing works
“It has been estimated that 15% of the population of women between the ages of 18 and 50 years suffer from chronic pelvic pain.(5) The annual direct medical cost of chronic pelvic pain is estimated conservatively at $2.”
BackgroundMárki, G., Bokor, A., Rigó, J. J., & Rigó, A. (2017) · Human Reproduction · doi:10.1093/humrep/dex091 · Cited by 138 · see citing works
“Women with endometriosis report higher levels of health-related perceived distress as a result of their pain than women with chronic pelvic pain only or healthy controls (Mathias et al., 1996; Petrelluzzi et al., 2008).”
Pitts, M. K., Ferris, J., Smith, A. M. A., SHELLEY, J. M., & Richters, J. (2008) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.2008.tb01945.x · Cited by 130 · see citing works
Chronic pelvic pain: aetiology and therapy
Cheong, Y. C., & Stones, W. R. (2006) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2006.04.004 · Cited by 128 · see citing works
“Mathias et al (1996)1 performed a telephone survey of 17 927 US households and, of the 5263 women who agreed to participate, 773 (14.7”
BackgroundInfluentialBajalan, Z., Alimoradi, Z., & Moafi, F. (2019) · Gynecologic and Obstetric Investigation · doi:10.1159/000495408 · Cited by 128 · see citing works
Vulvodynia - an evidence-based literature review and proposed treatment algorithm
De Andres, J., Sanchis‐Lopez, N., Asensio‐Samper, J. M., Fabregat‐Cid, G., Villanueva‐Perez, V. L., Monsalve Dolz, V., & Minguez, A. (2016) · Pain Practice · doi:10.1111/papr.12274 · Cited by 127 · see citing works
Machan, L. S., & Durham, J. D. (2013) · Seminars in Interventional Radiology · doi:10.1055/s-0033-1359731 · Cited by 127 · see citing works
Khilnani, N. M., Meissner, M. H., Learman, L. A., Gibson, K. D., DANIELS, J. P., Winokur, R. S., Marvel, R. P., Machan, L. S., Venbrux, A. C., Tu, F. F., et al. (2019) · Journal of Vascular and Interventional Radiology · doi:10.1016/j.jvir.2018.10.008 · Cited by 124 · see citing works
D’Hooghe, T. M., & Hummelshøj, L. (2006) · Human Reproduction · doi:10.1093/humrep/del123 · Cited by 122 · see citing works
“…have a director who will co-ordinate the training programme, accept the main responsibility for its supervision and be actively involved; when more than one centre provides the programme, there must be a supervisor at each centre, with one designated as having overall responsibility.”
BackgroundInfluentialPatterns of diagnosis and referral in women consulting for chronic pelvic pain in UK primary care
Zondervan, K. T., Yudkin, P. L., Vessey, M. P., Dawes, M. G., Barlow, D. H., & Kennedy, S. (1999) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.1999.tb08141.x · Cited by 121 · see citing works
Gonadotrophin-releasing hormone analogues for pain associated with endometriosis
Brown, J., Pan, A., & Hart, R. J. (2010) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008475 · Cited by 121 · see citing works
Cross‐talk and sensitization of bladder afferent nerves
Ustinova, E. E., Fraser, M. O., & Pezzone, M. A. (2009) · Neurourology and Urodynamics · doi:10.1002/nau.20817 · Cited by 119 · see citing works
“2 million(1)), further research and multi-disciplinary approaches will no doubt improve patient quality of life and decrease direct and indirect annual costs to society, which currently is estimated to exceed $3 billion.(1) CPP not only encompasses pain syndromes of the pelvic cavity, such as interstitial cystitis/ pa…”
Pelvic Congestion Syndrome: Systematic Review of Treatment Success
Rizer, M., Alexander, R., Sharpe, E., Rochon, P. J., & Brown, C. (2018) · Seminars in Interventional Radiology · doi:10.1055/s-0038-1636519 · Cited by 119 · see citing works
The impact of endometriosis on work and social participation
Gilmour, J. A., Huntington, A., & Wilson, H. V. (2008) · International Journal of Nursing Practice · doi:10.1111/j.1440-172x.2008.00718.x · Cited by 118 · see citing works
The pelvic venous syndromes: Analysis of our experience with 57 patients
Scultetus, A. H., Villavicencio, J. L., Gillespie, D. L., Kao, T. C., & Rich, N. M. (2002) · Journal of Vascular Surgery · doi:10.1067/mva.2002.129114 · Cited by 117 · see citing works
Chronic Pelvic Pain: An Integrated Approach to Diagnosis and Treatment
Gunter, J. (2003) · Obstetrical & Gynecological Survey · doi:10.1097/01.ogx.0000083225.90017.01 · Cited by 113 · see citing works
“8 billion and indirect costs greater than $555 million (1).”
BackgroundRecommendations for the Design of Epidemiologic Studies of Endometriosis
Holt, V. L., & Weiss, N. S. (2000) · Epidemiology · doi:10.1097/00001648-200011000-00007 · Cited by 117 · see citing works
Gonadotrophin-releasing hormone analogues for pain associated with endometriosis
Prentice, A., Deary, A., Goldbeck-Wood, S., Farquhar, C., & Smith, S. (1999) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd000346 · Cited by 116 · see citing works
RetractedOvarian Varices in Healthy Female Kidney Donors: Incidence, Morbidity, and Clinical Outcome
Belenky, A., Bartal, G., Atar, E., Cohen, M., & Bachar, G. N. (2002) · American Journal of Roentgenology · doi:10.2214/ajr.179.3.1790625 · Cited by 115 · see citing works
Evidence-Based Management of Chronic Pelvic Pain
Reiter, R. C. (1998) · Clinical Obstetrics & Gynecology · doi:10.1097/00003081-199806000-00023 · Cited by 115 · see citing works
Souza, C. A., Oliveira, L. M., Scheffel, C., Genro, V. K., Rosa, V., Chaves, M. F., & Cunha Filho, J. S. (2011) · Health and Quality of Life Outcomes · doi:10.1186/1477-7525-9-41 · Cited by 113 · see citing works
“CPP is an important burden in women of reproductive age, with a direct impact on their marital, social and professional life [4,5].”
BackgroundEfficacy of static magnetic field therapy in chronic pelvic pain: A double-blind pilot study
Brown, C., Ling, F. W., Wan, J. Y., & Pilla, A. A. (2002) · American Journal of Obstetrics and Gynecology · doi:10.1067/mob.2002.128026 · Cited by 112 · see citing works
The prevalence of chronic pelvic pain in women in the United Kingdom: a systematic review
Zondervan, K. T., Yudkin, P. L., Vessey, M. P., Dawes, M. G., Barlow, D. H., & Kennedy, S. (1998) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.1998.tb09357.x · Cited by 111 · see citing works
Epidemiology of chronic pelvic pain
Zondervan, K. T., & Barlow, D. H. (2000) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1053/beog.1999.0083 · Cited by 111 · see citing works
The Economic Impact of Chronic Prostatitis
Customize your JAMA Network experience by selecting one or more topics from the list below. (2004) · Archives of Internal Medicine · doi:10.1001/archinte.164.11.1231 · Cited by 111 · see citing works
- Authors
- Mathias, S.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- Mathias, S
- ORCID
- Mathias, S
- Venue
- Obstetrics & Gynecology
- Published
- 1996-03
- Volume
- 87
- Issue
- 3
- Pages
- 321-327
- ISSN
- 0029-7844 (ISSN-L)
- OpenAlex
- W1985935279
- Cited by
- 1,074
- References
- 18
- Citations by year
- 2026: 16 · 2025: 36 · 2024: 29 · 2023: 49 · 2022: 36 · 2021: 45 · 2020: 37 · 2019: 39 · 2018: 50 · 2017: 53 · 2016: 46 · 2015: 38 · 2014: 55 · 2013: 37 · 2012: 51
- FWCI
- 11.94
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Menstrual Health and Disorders
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- chronic pelvic pain, prevalence, health-related quality of life, labor productivity, health care utilization, endometriosis, health care costs, women's health, lost workdays
- MeSH terms
- Adolescent, Adult, Chronic Disease, Endometriosis, Female, Health Services Needs and Demand, Humans, Middle Aged, Quality of Life, Socioeconomic Factors, United States, Prevalence, Cost of Illness, Pelvic Pain
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
