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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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“and 24%, respectively, in women of reproductive age.(6,7) The direct costs of CPP have been estimated at over $2.”
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“The rate of chronic pelvic pain was twice the general population prevalence.(4) Of these women, more than half experienced pain that was highly intensive.”
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Vincent, K. (2009) · Postgraduate Medical Journal · doi:10.1136/pgmj.2008.073494 · Cited by 73
“while in the USA CPP was reported by 14.7% of women of the same age range.”
BackgroundInfluentialGriffith, J. W., Stephens‐Shields, A. J., Hou, X., Naliboff, B. D., Pontari, M. A., Edwards, T. C., Williams, D. A., Clemens, J. Q., Afari, N., Tu, F. F., et al. (2015) · The Journal of Urology · doi:10.1016/j.juro.2015.11.012 · Cited by 71
Steege, J. F., & Siedhoff, M. T. (2014) · Obstetrics and Gynecology · doi:10.1097/aog.0000000000000417 · Cited by 72
Chronic pelvic pain – pain catastrophizing, pelvic pain and quality of life
Sewell, M., Churilov, L. P., Mooney, S. S., Ma, T., Maher, P. J., & Grover, S. R. (2018) · Scandinavian Journal of Pain · doi:10.1515/sjpain-2017-0181 · Cited by 71
“Indirect costs such as loss of work productivity, loss of employment, disability and absenteeism are estimated to cost the US 760 million USD per annum [4, 7, 8].”
BackgroundZoorob, D. G., South, M. M. T., Karram, M. M., Sroga, J. M., Maxwell, R. A., Shah, A. D., & Whiteside, J. L. (2014) · International Urogynecology Journal · doi:10.1007/s00192-014-2606-4 · Cited by 70
“[1].”
Validation of the Female Sexual Function Index in Women with Chronic Pelvic Pain
Verit, F. F., & Verit, A. (2007) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2007.00604.x · Cited by 70
Progestagens and anti-progestagens for pain associated with endometriosis
Kives, S. L., Brown, J., Prentice, A., Deary, A. J., & Bland, E. (2000) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002122 · Cited by 70
Is Sacral Nerve Stimulation an Effective Treatment for Chronic Idiopathic Anal Pain?
Falletto, E., Masin, A., Lolli, P., Villani, R. D., Ganio, E., Ripetti, V., Infantino, A., & Stazi, A. (2009) · Diseases of the Colon & Rectum · doi:10.1007/dcr.0b013e31819d1319 · Cited by 69
“5 million per year) and severe impairment of quality of life.(4) The etiology of chronic idiopathic anal pain remains to be fully elucidated.”
BackgroundWarren, J. W., LANGENBERG, P. W., & Clauw, D. J. (2012) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2012.09.002 · Cited by 68
“Additionally, we used symptom-based consensus definitions constructed by experts [12–18] for seven of these syndromes: FM, CFS, IBS, sicca, CPP,migraine, and panic disorder.”
MethodAngiogenesis lymphangiogenesis and neurogenesis in endometriosis
Hey‐Cunningham, A. J. (2013) · Frontiers in Bioscience-Elite · doi:10.2741/e682 · Cited by 68
“pain in women (6, 7); pain which can be debilitating and often has a negative impact on the ability to work, personal relationships and self-esteem (6, 8).”
BackgroundHanno, P. M. (2005) · International Urogynecology Journal · doi:10.1007/s00192-005-1301-x · Cited by 68
“Oral drug treatments that have been assessed for their safety and efficacy in randomised clinical trials and that have been published in peer reviewed journals are: amitriptyline [ 1 ], cimetidine, hydroxyzine [2], L-arginine, and pentosanpolysulfate.”
BackgroundMethodInfluentialPrevalence and Characteristics of Irritable Bowel Syndrome Among Women With Chronic Pelvic Pain
Williams, R. E., Hartmann, K. E., Sandler, R. S., Miller, W. C., & Steege, J. F. (2004) · Obstetrics and Gynecology · doi:10.1097/01.aog.0000135275.63494.3d · Cited by 68
ter Kuile, M. M., Weijenborg, P. T. M., & Spinhoven, P. (2009) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2009.01414.x · Cited by 66
Thomson, A. J. M., Jarvis, S. K., Lenart, M., Abbott, J. A., & Vancaillie, T. G. (2005) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2004.00315.x · Cited by 66
Psychosocial and economic impact of chronic pelvic pain
Stones, W. R., Selfe, S. A., Fransman, S., & Horn, S. A. (2000) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1053/beog.1999.0084 · Cited by 66
Interventions for treating chronic pelvic pain in women
Stones, W., Cheong, Y. C., Howard, F. M., & Singh, S. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd000387.pub2 · Cited by 66
RetractedThe Economic Impact of Uterine Fibroids in the United States: A Summary of Published Estimates
Mauskopf, J., Flynn, M., Thieda, P., Spalding, J. R., & DuChane, J. (2005) · Journal of Women s Health · doi:10.1089/jwh.2005.14.692 · Cited by 65
The association of dysmenorrhea with noncyclic pelvic pain accounting for psychological factors
Westling, A. M., Tu, F. F., Griffith, J. W., & Hellman, K. M. (2013) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2013.08.020 · Cited by 65
Prevalence of interstitial cystitis in young women
Parsons, C. L., & Tatsis, V. (2004) · Urology · doi:10.1016/j.urology.2004.06.044 · Cited by 65
The epidemiology of interstitial cystitis: is it time to expand our definition?
Kusek, J. W., & Nyberg, L. M. (2001) · Urology · doi:10.1016/s0090-4295(01)01141-4 · Cited by 63
Leserman, J., Zolnoun, D., Meltzer-Brody, S., Lamvu, G., & Steege, J. F. (2006) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2006.03.071 · Cited by 62
“(1) Diffuse abdominal/pelvic pain (42.”
BackgroundMethodResultInfluentialA Systematic Review of the Cost of Chronic Pelvic Pain in Women
Huang, G., Le, A.-L., Goddard, Y., James, D., Thavorn, K., Payne, M., & Chen, I. (2021) · Journal of Obstetrics and Gynaecology Canada · doi:10.1016/j.jogc.2021.08.011 · Cited by 62
Factors Influencing Outcome in Consultations for Chronic Pelvic Pain
Selfe, S. A., Matthews, Z., & Stones, W. R. (1998) · Journal of Women s Health · doi:10.1089/jwh.1998.7.1041 · Cited by 62
Chronic orchialgia: epidemiology, diagnosis and evaluation
Sigalos, J. T., & Pastuszak, A. W. (2017) · Translational Andrology and Urology · doi:10.21037/tau.2017.05.23 · Cited by 62
“Chronic pelvic pain affects approximately 15% of women 18– 50 years old (2).”
Background
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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