Psychiatric aspects of pelvic pain in women

Chronic pelvic pain (lower area) in women is a common syndrome that affects the woman’s day to day life and prevents her from feeling healthy and well.

Psychiatric aspects of pelvic pain in women

It has been established that 15% of women suffer from it, and 40% of women who attend gynaecology Outpatient clinics complain of chronic pelvic pain. Although there are various definitions for chronic pelvic pain, a common definition describes it as a painful condition in the area below the belly, which has been present intermittently or continuously for at least six months, coinciding with menstruation or independent from it.

Psychiatric classification of chronic pelvic pain

According to psychiatric classification chronic pelvic pain, for which no underlying physical cause can be found, is regarded under the heading of “somatoform disorders”. Such patients can display various additional psychosomatic symptoms, like sexual dysfunction, gastroenterological complaints, headaches, circulation problems, premenstrual complaints.

Physical causes of chronic pelvic pain

Patients with chronic pelvic pain, who are sent to the Outpatient clinic for psychosomatic disorders, are often “difficult” patients, as they have consulted a practitioner for their physical complaint, but in spite of detailed tests and investigations no physical reason could be established that might explain the presence of the pain. This difficulty often leads to a conflict in the doctor-patient relationship; the patient might terminate treatment early or change her doctor. Sometimes the patient’s symptoms get exacerbated.

When questioning co-morbidity in psychiatric assessments it is essential that, like in other chronic pain cases, depression is investigated and treated.