Chronic pelvic pain
Chronic pelvic pain – replacing ignorance with competence. A population-based joint venture study on scope, diagnostics and burden
Chronic pelvic pain is defined as chronic or persistent pain perceived in structures related to the pelvis of either men or women. It is often associated with negative cognitive, behavioural, sexual and emotional consequences as well as with symptoms suggestive of lower urinary tract (LUT), sexual, bowel, pelvic floor or gynaecological dysfunction (1).
Chronic pelvic pain (CPP) affects men and women of all ages, and prevalence studies are scarce (2). Chronic pain disproportionately affects women with low income and education and is thus a major driver of gender inequality and socio-economic disparity in health (3). The global burden of chronic disease is increasing (4), and gynaecological conditions rank second among causes of years lived with disability (YLD) for women, accounting for 6.17% of YLD worldwide (5). Pain related to the pelvic area is associated with shame, is poorly understood and studied, validated screening tools and standardized diagnostic procedures are lacking, and management options are limited(6, 7). High-quality health care can hardly be delivered if the patient is not diagnosed. CPP frequently has profound impact on women’s sex life, desire to have a family, work participation, and quality of life (8). However, the knowledge gap on CPP regarding prevalence, diagnostics, disease- and societal burden and impact for the patient is huge.
The project was launched in autumn 2023, and is funded by the Norwegian research Council. The project is anchored at IKM, UiT, but will be done in close cooperation with several stakeholders; University Hospital of North Norway, The Norwegian health institute, NTNU, Norwegian Women's Public Health Association and the Norwegian Labour and Welfare Administration. This multidisciplinary study combines clinical and social science research in close partnership with patients, patient organizations, and welfare services.
Prof Heidi Tiller is the project leader. MD Kristine Amundsen started as PhD student in one of 3 work packages August 2023. The PhD project will use data from 3 population-based study cohorts (The Tromsø Study, Fit Futures and SHoT) to assess prevalence, general characteristics and pain sensitivity in women reporting chronic pelvic pain (CPP) in a Norwegian population. In addition, there will be 2 work packages organized as post docs, focusing on patient experiences and societal burden.
Our research will contribute to increased knowledge on the condition Chronic pelvic pain, and contribute to development of clinically validated screening tools which can aid clinicians in primary and specialized care institutions.
- Engeler D BA, Berghmans B, Birch J, Borovicka J, et al. EAU Guidelines on Chronic Pelvic Pain Uroweb.org2022 [Available from: https://d56bochluxqnz.cloudfront.net/documents/full-guideline/EAU-Guidelines-on-Chronic-Pelvic-Pain-2023.pdf.
- Ahangari A. Prevalence of chronic pelvic pain among women: an updated review. Pain Physician. 2014;17(2):E141-7.
- Azevedo LF, Costa-Pereira A, Mendonca L, Dias CC, Castro-Lopes JM. Epidemiology of chronic pain: a population-based nationwide study on its prevalence, characteristics and associated disability in Portugal. J Pain. 2012;13(8):773-83.
- Murray CJ, Lopez AD. Measuring the global burden of disease. N Engl J Med. 2013;369(5):448-57.
- IHME. healthdata.org 2022 [Available from: https://www.healthdata.org/.
- Ayorinde AA, Macfarlane GJ, Saraswat L, Bhattacharya S. Chronic pelvic pain in women: an epidemiological perspective. Womens Health (Lond). 2015;11(6):851-64.
- Fall M, Baranowski AP, Elneil S, Engeler D, Hughes J, Messelink EJ, et al. EAU guidelines on chronic pelvic pain. Eur Urol. 2010;57(1):35-48.
- Sperschneider ML, Hengartner MP, Kohl-Schwartz A, Geraedts K, Rauchfuss M, Woelfler MM, et al. Does endometriosis affect professional life? A matched case-control study in Switzerland, Germany and Austria. BMJ Open. 2019;9(1):e019570.