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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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“Die Prävalenzrate der Störung liegt bei Frauen im reproduktionsfähigen Alter bei bis zu 40%, wobei etwa 10% aller ambulanten gynäkologischen Konsultationen und nahezu 20% aller Laparoskopien auf CUBB entfallen [Hodgkiss und Watson, 1994; Mathias et al., 1996; Reiter, 1990].”
BackgroundTorosis, M., Carey, E. T., Christensen, K., Kaufman, M. R., Kenton, K. S., Kotarinos, R. K., Lai, H. H., Lee, U. J., Lowder, J. L., Meister, M., et al. (2023) · medRxiv · doi:10.1101/2023.08.11.23293953 · Cited by 2
“(1) (2) High-tone pelvic floor disorder 91 (HTPFD), a chronic pelvic floor disorder characterized by tight, weakened, and/or painful pelvic 92”
BackgroundUnderstanding and addressing female pelvic pain ‐ a multifaceted challenge
Tellum, T., & Jurkovic, D. (2023) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1111/aogs.14682 · Cited by 2
Laparoscopic uterosacral nerve block: A fertility preserving option in chronic pelvic pain
Jones, B. P., Saso, S., Bracewell‐Milnes, T., Barcroft, J., Borley, J., Goroszeniuk, T., Lathouras, K., Yazbek, J., & SMITH, J. (2019) · AIMS Medical Science · doi:10.3934/medsci.2019.4.260 · Cited by 1
Chronic pelvic pain and pelvic organ prolapse: a consequence of upright position?
Goeschen, K., & Liedl, B. (2020) · Pelviperineology · doi:10.34057/ppj.2020.39.02.005 · Cited by 1
Tafti, D. A., Krause, K., Dillon, R., Flores, R., & Cecava, N. D. (2020) · Radiology Case Reports · doi:10.1016/j.radcr.2020.09.041 · Cited by 1
“[17] Mathias SD, Kuppermann M, Liberman RF, Lipschutz RC, Steege JF.”
BackgroundSepúlveda-Torres, M., Carvajal, C., & Álvaro Cavieres, F. (2021) · Revista médica de Chile · doi:10.4067/s0034-98872021000701023 · Cited by 1
Syndrome de congestion pelvienne : une cause fréquente de douleur chronique
Ney, B., Diserens, C., & Vial, Y. (2020) · JMIG · doi:10.53738/revmed.2020.16.712.2042 · Cited by 1
Pelvic Congestion Syndrome (PCS)
Whiteley, M. S., White, A. M., & Beckett, D. (2024) · Springer eBooks · doi:10.1007/978-3-031-42735-0_79 · Cited by 1
Anatomical neuromuscular variations determined by magnetic resonance imaging in chronic pelvic pain
Peng, Y., Sach, T. A., Chow, J., & Abbott, J. A. (2024) · Journal of Endometriosis and Pelvic Pain Disorders · doi:10.1177/22840265241303813 · Cited by 1
Practical Application of Value‐Based Medicine in Chronic Pelvic Pain: A Qualitative Study
Wissing, M. C., van der Wal, S. E. I., van de Haterd, M., de Reuver, P. R., Dick, L., Engels, Y., Vissers, K. C. P., Kluivers, K. B., & Notten, K. J. B. (2024) · Journal of Evaluation in Clinical Practice · doi:10.1111/jep.14295 · Cited by 1
Medical expenditures associated with abdominal and pelvic pain in the United States, 2017-2021
Li, R., Tham, S. W., Basu, A., Palermo, T. M., Dang, T. T., & Groenewald, C. B. (2025) · Journal of Pain · doi:10.1016/j.jpain.2025.104793 · Cited by 1
The Role of Psychologists in Treating Pelvic Pain Conditions
Gernand, A. K., Allen, D. L., Lupe, S. E., & Simons, M. L. (2025) · Clinics in Colon and Rectal Surgery · doi:10.1055/s-0045-1804499 · Cited by 1
Good long-term results of sacral neuromodulation for endometriosis related chronic pelvic pain
Zegrea, A., Ojala, E., Kirss, J., Suvitie, P. A., Varpe, P., Mäkelä‐Kaikkonen, J., Rautio, T., Seikkula, J., Ukkonen, M. T., Lavonius, M. I., et al. (2025) · BMC Women s Health · doi:10.1186/s12905-025-03699-y · Cited by 1
“All the patients had previously undergone at least one surgery due to endometriosis, with a median of 3 [1–6] operations.”
InfluentialBeckenvenenerkrankungen – Diagnostik und Therapie
Almeida, G. G., Akrap, D., Huch, R., & Kostrzewa, M. (2025) · Radiologie up2date · doi:10.1055/a-2552-7235 · Cited by 1
Serum Galectin-1 as a Diagnostic Biomarker in Endometriosis: A Prospective Longitudinal Study
Brubel, R., Balogh, D. B., Polgár, B., Szereday, L., Hudelist, G., Ács, N., & Bokor, A. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms262110390 · Cited by 1
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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