Pelvic Pain in Female

Chronic pelvic pain in women is defined as persistent, noncyclic pain perceived to be in structures related to the pelvis and lasting more than six months. Chronic pelvic pain is defined as pain in the lower abdomen or pelvis, of at least six months duration, occurring continuously or intermittently, not associated exclusively with menstruation or sexual intercourse. Vulvodynia is defined as a chronic disorder in women, characterised by provoked or constant vulvar pain of varying intensity without obvious concomitant clinical pathology

"Urogenital Pain Syndrome" includes interstitial cystitis, vulvodynia, urethral syndrome, coccyodynia, and perineal pain

Interstitial Cystitis
Interstitial cystitis is characterized by pelvic pain and urinary urgency and frequency which may be associated with other symptoms, particularly dyspareunia sometimes relieved by voiding. Frequently, women give a history of repeated urinary tract infections but with negative cultures. Multidisciplinary treatment regimens are likely to be most successful, including a combination of dietary modification, pharmacological agents and physical therapy.

Urethral Syndrome
Urethral syndrome is also characterized by urinary urgency, frequency, dysuria, and suprapubic/lower back pain without any obvious cause. Dysfunction of the pelvic floor may be involved as success is often achieved with skeletal muscle relaxants or electrostimulation and biofeedback.

Musculoskeletal Factors in Chronic Pelvic Pain
Fibromyalgia
Trigger point

Vulval Pain Syndromes
Although not truly pelvic pain, the vulval pain syndromes (vulvodynia and vestibulodynia) exhibit many features which are similar to CPP, and the two can coexist in a urogenital pain syndrome.

Because vulval pain syndromes are almost invariably associated with dyspareunia in sexually active women, sexual dysfunction is also common, with secondary problems such as vaginismus and anorgasmia.

Pain can also occur on urination and defecation
Chronic vulvar pain or discomfort for which no obvious etiology can be found, ie, vulvodynia, can affect up to 16% of women. It may affect girls and women across all age groups and ethnicities. Vulvodynia is a significant burden to society, the health care system, the affected woman, and her intimate partner. The etiology is multifactorial and may involve local injury or inflammation, and peripheral and or central sensitization of the nervous system.