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Feature Article

Chronic pelvic pain in women: the role of primary care

Elizabeth Armari, Sonya Ting

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Abstract

Chronic pelvic pain has multiple, intertwined aetiologies and is challenging to manage within short consultation times. General practice is often the starting point for evaluation of affected women and plays an important part in continuity of care and long-term follow up. Prompt management of dysmenorrhoea and dyspareunia may reduce the burden of chronic pelvic pain.

Key Points

  • Chronic pelvic pain (CPP) is a chronic or persistent pain perceived in structures related to the pelvis associated with negative cognitive, behavioural and sexual consequences in nonpregnant women lasting for more than six months.
  • Women with CPP may also experience coexisting migraine or lower back pain.
  • A comprehensive patient history is the most valuable tool in assessing a woman with CPP and is reliant on a strong patient–doctor relationship, coupled with regular follow up to overcome the barriers of time-limited general practice settings.
  • Timely management of acute pain syndromes such as dysmenorrhoea or dyspareunia is achievable in primary practice settings, and provides important opportunities to prevent the development of CPP.
  • Management approaches should prioritise improved function and general wellbeing over cure, with nonpharmacological approaches including physiotherapy intervention, psychological counselling and management of comorbidities as central components.

    Picture credit: © Science Source/DNA Illustrations

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