Cited by 1,074Endometriosis Research and TreatmentMenstrual Health and DisordersMusculoskeletal pain and rehabilitation

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Chronic Pelvic Pain: Prevalence, Health-Related Quality of Life, and Economic Correlates

Mathias, S·1996·Obstetrics & Gynecology

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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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Chuang, F., Yang, T., & Kuo, H. (2020) · LUTS Lower Urinary Tract Symptoms · doi:10.1111/luts.12334 · Cited by 16
“It is a complex and usually multifactorial condition affecting more than just the pelvis.(1) Considerable emphasis is placed on diagnostic laparoscopy because of the difficulty in the identification and treatment of endometriosis, pelvic adhesions, and postinflammatory changes.”
Background
Measurement of pain and anthropometric parameters in women with chronic pelvic pain
Ferreira, M. B. C., Mitidieri, A. M. D. S., da Silva, J. B., da Silva, A. P. M., Pazin, C., Poli‐Neto, O. B., Nogueira, A. A., dos Reis, F. J. C., & Silva, J. C. R. E. (2014) · Journal of Evaluation in Clinical Practice · doi:10.1111/jep.12221 · Cited by 16
“Chronic pelvic pain (CPP) is a debilitating condition for women, with a strong impact on quality of life and significant costs for the health services [1].”
Background
Ultrasound Evaluation of Gynecologic Causes of Pelvic Pain
Cicchiello, L. A., Hamper, U. M., & Scoutt, L. M. (2010) · Ultrasound Clinics · doi:10.1016/j.cult.2010.03.005 · Cited by 16
The prevalence of continuing chronic pelvic pain following a negative laparoscopy
RICHMOND, D. F. D. T. C. L. M. N. (1998) · Journal of Obstetrics and Gynaecology · doi:10.1080/01443619867434 · Cited by 16
Chronic pelvic pain: The general practitioner's perspective
McGowan, L., Pitts, M. K., & Carter, D. C. (1999) · Psychology Health & Medicine · doi:10.1080/135485099106234 · Cited by 16
Calcitonin Gene-Related Peptide and Substance P As Predictors of Venous Pelvic Pain
Gavrilov, S. G., Vasilieva, G. Y., Vasiliev, I. M., & Efremova, O. I. (2019) · Acta Naturae · doi:10.32607/20758251-2019-11-4-88-92 · Cited by 16
A Multidisciplinary Pelvic Pain Clinic: Integrated Health Psychology in a Specialty Care Setting
Thomas, E. B. K., Stegall, M. S., Farley, K. E., & Pawlak, S. A. (2022) · Journal of Women s Health · doi:10.1089/jwh.2022.0072 · Cited by 15
Myofascial pelvic pain: the forgotten player in chronic pelvic pain
Namazi, G., Chauhan, N., & Handler, S. J. (2024) · Current Opinion in Obstetrics & Gynecology · doi:10.1097/gco.0000000000000966 · Cited by 18
Women with Chronic Pelvic Pain Demonstrate Increased Lumbopelvic Muscle Stiffness Compared to Asymptomatic Controls
Proulx, L., Brizzolara, K. J., Thompson, M., Wang-Price, S. S., Rodríguez, P., & Koppenhaver, S. L. (2022) · Journal of Women s Health · doi:10.1089/jwh.2022.0198 · Cited by 15
Irritable bowel syndrome in women with chronic pelvic pain in a Northeast Brazilian city
Lessa, L. M. M., Chein, M. B. D. C., da Silva, D. S. M., Poli‐Neto, O. B., Nogueira, A. A., Coelho, L. S. C., & Brito, L. M. O. (2013) · Revista Brasileira Ginecologia e Obstetrícia · doi:10.1590/s0100-72032013000200008 · Cited by 15
Anterior Vaginal Wall Tenderness (AVWT) as a Physical Symptom in Chronic Pelvic Pain
Paulson, J. D., & Paulson, J. N. (2011) · JSLS Journal of the Society of Laparoscopic & Robotic Surgeons · doi:10.4293/108680810x12924466008961 · Cited by 15
Pelvic Congestion Syndrome
Karçaaltıncaba, M., Karçaaltıncaba, D., & Dogra, V. S. (2008) · Ultrasound Clinics · doi:10.1016/j.cult.2008.08.002 · Cited by 15
Female Chronic Pelvic Pain: The Journey to Diagnosis and Beyond
Twiddy, H., Bradshaw, A., Chawla, R., Johnson, S., & Lane, N. (2017) · Pain Management · doi:10.2217/pmt-2016-0052 · Cited by 15
An observational cohort study of pelvic floor photobiomodulation for treatment of chronic pelvic pain
Kohli, N., Jarnagin, B. K., Stoehr, A. R., & Lamvu, G. (2021) · Journal of Comparative Effectiveness Research · doi:10.2217/cer-2021-0187 · Cited by 14
Inferior hypogastric plexus blockade versus acupuncture for the management of idiopathic chronic pelvic pain: A randomized clinical trial
Alsammani, M., Ahmed, S., Amin, M., Ait-Allah, A. S., Ali, A. E.-S., & Salem, R. (2015) · Biomedical Journal · doi:10.4103/2319-4170.151034 · Cited by 14
Psychosomatische Aspekte der Endometriose – aktueller Stand der wissenschaftlichen Kenntnisse und der klinischen Erfahrungen
Leeners, B., & Imthurn, B. (2007) · Gyn�kologisch-geburtshilfliche Rundschau · doi:10.1159/000102575 · Cited by 14
“Betroffene Frauen berichten, dass ihre Beschwerden oftmals uber lange Zeit nicht ernst genommen, sondern entweder als normales Frauenleiden oder als psychische Storung klassifiziert wurden. In den meisten Fallen resultierte aus dieser arztlichen Auffassung keine konkrete Hilfestellung. Einflussfaktoren Schmerz Chronis…”
Background
Utilization of Health Care Services and Ambulatory Resources Associated with Chronic Noncancer Pain
Kay, C., Wozniak, E. M., & Bernstein, J. (2016) · Pain Medicine · doi:10.1093/pm/pnw336 · Cited by 14
Pelvic Congestion Syndrome: A Missed Opportunity
Kaufman, C. S., & Little, N. A. (2021) · Indian journal of radiology and imaging - new series/Indian journal of radiology and imaging/Indian Journal of Radiology & Imaging · doi:10.1055/s-0041-1735497 · Cited by 14
Avaliação postural em mulheres com dor pélvica crônica
Miranda, R., Schor, E., & Girão, M. J. B. C. (2009) · Revista Brasileira Ginecologia e Obstetrícia · doi:10.1590/s0100-72032009000700006 · Cited by 14
A Review of Select Centralized Pain Syndromes
Spiegel, D. R., Chatterjee, A. S., Mccroskey, A. L., Ahmadi, T., Simmelink, D., Oldfield, E. C., Pryor, C. R., Faschan, M., & Raulli, O. (2015) · Health Services Research and Managerial Epidemiology · doi:10.1177/2333392814567920 · Cited by 14
Diagnosis and management of chronic pelvic pain
Lifford, K. L., & Barbieri, R. L. (2002) · Urologic Clinics of North America · doi:10.1016/s0094-0143(02)00054-x · Cited by 13
“In a telephone survey of 5263 women of reproductive age, 15% reported chronic pelvic pain that was active during the past 3 months [2].”
Background
Differential diagnosis of chronic pelvic pain in women: the urologist's approach
Fletcher, S. G., & Zimmern, P. E. (2009) · Nature Reviews Urology · doi:10.1038/nrurol.2009.178 · Cited by 14
“In the USA, a large poll found that 16% of women with CPP had experienced either constant or intermittent pelvic pain during the preceding 6 months, and direct costs of health care for this disorder are estimated at USd880 million per year”
Background
Variation in practice of laparoscopic uterosacral nerve ablation: a European survey
Latthe, P. M., Powell, R. J., DANIELS, J. P., Hills, R. K., Gray, R. G., Gupta, J., & Khan, K. S. (2004) · Journal of Obstetrics and Gynaecology · doi:10.1080/01443610410001722626 · Cited by 14
“Chronic pelvic pain, often defined as constant or intermittent, cyclic or acyclic pelvic pain, that persists for 6 months ormore (Vercellini et al., 1990), has a high prevalence estimated between 14 and 24% (Mathias et al., 1996; Zondervan et al., 2001).”
Background
Mindfulness-Based Stress Reduction for Military Women With Chronic Pelvic Pain: A Feasibility Study
Crisp, C. D., Hastings‐Tolsma, M., & Jonscher, K. R. (2016) · Military Medicine · doi:10.7205/milmed-d-15-00354 · Cited by 14
Non-pharmacological therapies for treating chronic pelvic pain in women: A review
Wang, X., Ding, N., Sun, Y., Chen, Y., Shi, H., Zhu, L., Gao, S., & Liu, Z. (2022) · Medicine · doi:10.1097/md.0000000000031932 · Cited by 13
“[1,4] In the US, CPP causes almost 15% female off-work and a 45% decrease in working productivity.[5] CPP in the US accounts for 10% of gynecologic clinic visits and 40% of laparoscopies,[5,6] which cost $880 million annually.”
Background
Laparoscopic Appendectomy in Women Without Identifiable Pathology Undergoing Laparoscopy for Chronic Pelvic Pain
Lal, A. K., Weaver, A. L., Hopkins, M. R., & Famuyide, A. O. (2013) · JSLS Journal of the Society of Laparoscopic & Robotic Surgeons · doi:10.4293/108680812x13517013317031 · Cited by 13
Chronic pelvic pain in Spanish women: prevalence and associated risk factors. A cross-sectional study
Díaz-Mohedo, E., Wärnberǵ, J., Barón-López, F. J., Velasco, S., & Burgos, A. C. (2014) · Clinical and Experimental Obstetrics & Gynecology · doi:10.12891/ceog16632014 · Cited by 13
Impact of Deployment on Reproductive Health in U.S. Active-Duty Servicewomen and Veterans
Gawron, L. M., Mohanty, A. F., Kaiser, J. E., & Gundlapalli, A. V. (2018) · Seminars in Reproductive Medicine · doi:10.1055/s-0039-1678749 · Cited by 13
Chronic pelvic pain syndrome: Highlighting medicinal plants toward biomolecules discovery for upcoming drugs formulation
Salehi, B., Butnariu, M., Corneanu, M., Sărac, I., Vlaisavljević, S., Kitić, D., Rahavian, A., Abedi, A. R., Karkan, M. F., BHATT, I. D., et al. (2019) · Phytotherapy Research · doi:10.1002/ptr.6576 · Cited by 13
“First, the study of the patient history (Engeler et al., 2013; Mathias, 1996; Nickel & Weidner, *Traditional classification.”
BackgroundInfluential
Clinical Outcomes of a Multidisciplinary Female Chronic Pelvic Pain Program
Westbay, L. C., Adams, W., Kistner, M., Brincat, C., Bresler, L., Yang, L. C., & Fitzgerald, C. M. (2021) · Urogynecology · doi:10.1097/spv.0000000000001045 · Cited by 14
Symptom resolution after hysterectomy and alternative treatments for chronic pelvic pain: does depression make a difference?
Learman, L. A., Gregorich, S. E., Schembri, M. E., Jacoby, A. F., Jackson, R., & Kuppermann, M. (2011) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2010.12.051 · Cited by 13
Complementary and Alternative Medications for Chronic Pelvic Pain
Leong, F. C. (2014) · Obstetrics and Gynecology Clinics of North America · doi:10.1016/j.ogc.2014.05.001 · Cited by 13
Discriminating power of CPPQ‐Mohedo: a new questionnaire for chronic pelvic pain
Díaz-Mohedo, E., Barón-López, F. J., Galán, C. P., Dawid-Milner, M. S., Suárez-Serrano, C., & Medrano-Sánchez, E. M. (2011) · Journal of Evaluation in Clinical Practice · doi:10.1111/j.1365-2753.2011.01778.x · Cited by 13

Authors: Mathias, S.
Affiliations: University of North Carolina at Chapel Hill (US)
Corresponding author: Mathias, S
ORCID: Mathias, S
Venue: Obstetrics & Gynecology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1996-03
Volume: 87
Issue: 3
Pages: 321-327
ISSN: 0029-7844 (ISSN-L)
DOI: 10.1016/0029-7844(95)00458-0
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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Chronic Pelvic Pain: Prevalence, Health-Related Quality of Life, and Economic Correlates

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