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Noncyclic Chronic Pelvic Pain Therapies for Women

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Background: Definition of Noncyclic CPP and Its Prevalence

There is minimal consensus on a definition for noncyclic CPP. The American College of Obstetrics and Gynecology defines CPP as intermittent or constant pain over at least 6 months in the lower abdomen or pelvic area that is of sufficient severity that it impedes activities of daily living or causes functional disability or leads to medical care. In practice and in current research, the diagnosis of CPP may be made as early as 3 months after onset of pain. For the purposes of this review, noncyclic CPP is defined as pain that has persisted for more than 3 months, is localized to the anatomic pelvis (i.e., lower abdomen below the umbilicus), and is of sufficient severity that it causes the patient to become functionally disabled or to seek medical care. This review focused on women over the age of 18 with CPP. The CPP must always have a noncyclic component; however, there could also be cyclic pain in some individuals.

Noncyclic CPP excludes chronic pelvic pain that is limited to dysmenorrhea (pain with menstruation), dyspareunia (pain with intercourse), dyschezia (pain with bowel movement), or dysuria (pain with urination).

Prevalence estimates for noncyclic CPP vary widely due to variability in study quality and definitions for CPP. In a systematic review of worldwide prevalence of noncyclic CPP, reported prevalence rates ranged from 4.0 to 43.4 percent in 18 studies that included 299,740 women.