Gynecologic Etiologies of Chronic Pelvic Pain

  • Aaron K. Styer


Chronic pelvic pain (CPP) is a common diagnostic and management dilemma which spans a wide diversity of clinical settings. One of the most significant challenges in the diagnosis and treatment of this disorder lies in a lack of consensus of diagnostic criteria. Although there is no gold standard definition, most diagnostic criteria for any pain disorder such as this are predicated on the duration (chronicity), location, and severity of symptoms. In gynecologic publications, the majority of authors have used duration of 6 months or more as the major diagnostic criterion for the definition of chronicity [1]. Despite general agreement regarding chronicity, some controversy exists with regard to temporal characteristics of symptoms. Many have debated whether acceptable symptoms for the diagnosis of CPP should include cyclic (e.g., dysmenorrhea associated with menses or pain during a particular phase of the menstrual cycle), intermittent (e.g., dyspareunia), or noncyclic pain (unpredictable onset). There is also disagreement of what constitutes the “pelvic” location of symptoms. Although CPP has been traditionally considered to be a process of the peritoneal and lower abdominal viscera below the umbilicus and within the boundaries of the anatomic pelvis, some authors have also included portions of the external genitalia (vulva, vagina) and musculoskeletal system (e.g., sacroiliac joint) in close proximity to the bony pelvis.


Irritable Bowel Syndrome Pelvic Pain GnRH Agonist Pelvic Inflammatory Disease Interstitial Cystitis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



I would like to express my sincerest gratitude to Drucilla J. Roberts, MD, and Susanna I. Lee, MD, PhD, for their contributions (figure images) to this chapter.


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© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Aaron K. Styer
    • 1
  1. 1.Vincent Department of Obstetrics and Gynecology, Vincent Reproductive Medicine and IVFMassachusetts General Hospital, Harvard Medical SchoolBostonUSA

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