Title:
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The epidemiology of chronic pelvic pain in women
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Background: Epidemiological studies on chronic pelvic pain (CPP) mainly focused on women of reproductive age so it is not clear whether there is any evidence of a distinct epidemiology at older ages. Therefore, the primary aim of this study was to establish the epidemiological characteristics of CPP whilst including women beyond the reproductive age. Methods: A cross-sectional postal survey was conducted amongst 5300 randomly selected women aged ≥25 years resident in the Grampian region, UK. Factors associated with CPP, poor health state and passive/active coping strategies were assessed using logistic regression. To identify sub-groups of CPP cases, cluster analysis was performed using variables of pain severity, psychosocial factors and pain coping strategies. Results: Of 2088 participants, 309 reported CPP (prevalence 14.8%). Prevalence was higher among women of reproductive years compared to older women (20.5% v. 9.6%). CPP was significantly associated with having multiple non-pain somatic symptoms, having fatigue and depression. CPP was more strongly associated with multiple non-pain somatic symptoms among older women compared to women of reproductive age but no other factor was found to be differentially related to CPP in the post-reproductive years. Poor health states among CPP cases were not strongly associated with pain intensity and duration but associated with depression, sleep disturbance, fatigue and passive coping. Women with CPP often engage passive coping strategy which was strongly associated with severe and constant pain, fatigue and multiple somatic symptoms. Two distinct groups of CPP cases characterised by the absence/presence of psychosocial distress were identified. Conclusion: This study provides a more accurate prevalence estimate for CPP which will aid healthcare planning and resource allocation. The associations identified for CPP are similar to those often reported for chronic pain conditions suggesting that they may have similar underlying mechanism. This study offers a basis for additional comprehensive and prospective evaluation of CPP and could inform the development of CPP management strategies.
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