Approach to Diagnosis and Management of Chronic Pelvic Pain in Women: Incorporating Chronic Overlapping Pain Conditions in Assessment and Management

Obstet Gynecol Clin North Am. 2022 Jun;49(2):219-239. doi: 10.1016/j.ogc.2022.02.006.


Chronic pelvic pain (CPP) is multifactorial in etiology and heterogeneous in presentation. Identification of all pain contributors is essential for successful management. Chronic overlapping pain conditions (COPCs) are a specified group of chronic pain conditions that commonly co-occur in patients. We briefly review individual COPCs and highlight risk factors and mechanisms that appear to be applicable across COPCs. We review evaluation and communication strategies that may help establish a productive therapeutic relationship between clinicians and patients. Management should include treatment of peripheral pain generators as well as co-occurring psychological conditions and central sensitization when present.

Keywords: Central sensitization; Endometriosis; Pelvic myofascial pain; Vulvodynia.

Publication types

  • Review

MeSH terms

  • Chronic Disease
  • Chronic Pain* / diagnosis
  • Chronic Pain* / etiology
  • Chronic Pain* / therapy
  • Female
  • Humans
  • Pelvic Pain / diagnosis
  • Pelvic Pain / etiology
  • Pelvic Pain / therapy