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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.
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“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]
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“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).”
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“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.”
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BackgroundEvaluation and Management of Women With Endometriosis
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“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.”
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“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).”
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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
Machan, L. S., & Durham, J. D. (2013) · Seminars in Interventional Radiology · doi:10.1055/s-0033-1359731 · Cited by 127
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
D’Hooghe, T. M., & Hummelshøj, L. (2006) · Human Reproduction · doi:10.1093/humrep/del123 · Cited by 124
“…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
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
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
“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
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
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
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
“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
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
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
Evidence-Based Management of Chronic Pelvic Pain
Reiter, R. C. (1998) · Clinical Obstetrics & Gynecology · doi:10.1097/00003081-199806000-00023 · Cited by 115
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
“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
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 112
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 113
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
Metadata
- 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 › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › 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
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