A Woman Who Suffers Always and Forever: Management of Chronic Pelvic Pain

Abstract

Chronic pelvic pain (CPP) in women is a long-lasting condition and affects about 5–26 % of women in the general population. The pathogenesis is poorly understood. The role of various somatic factors, such as endometriosis and adhesions, as a cause of pelvic pain have been studied thoroughly, but the association between identified pathologies and the (severity and location of) pain remains unclear. CPP can have a significant impact on physical and mental health in the affected women, resulting in distress and disability. Pain adjustment, pain appraisals, and pain coping strategies are important factors that can maintain and even worsen the individual experience of pain. So far, there is a paucity of studies demonstrating the effectiveness of any surgical or nonsurgical intervention on pain in CPP women. Therefore, like in other chronic pain conditions, it seems valid to concentrate treatment on pain maintaining factors. A cognitive behavioral approach of CPP women is explained and is illustrated with a case history. Following this approach a pain management program tailored to a patient’s needs can be offered.