Chronic pelvic pain in women of reproductive and post-reproductive age: a population-based study

A A Ayorinde, S Bhattacharya, K.L. Druce, G.T. Jones, Gary J. Macfarlane

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Background: Epidemiological studies on chronic pelvic pain (CPP) have focused on women of reproductive age. We aimed to determine the prevalence of chronic pelvic pain (CPP) in adult women and the differences in associated factors among women of reproductive age and older women. Also, to determine whether distinct sub-groups existed among CPP cases.
Methods: A cross-sectional postal survey was conducted amongst 5300 randomly selected women aged ≥25 years resident in the Grampian region, UK. Multivariable logistic regression was used to determine pregnancy-related and psychosocial factors associated with CPP. To identify sub-groups of CPP cases, we performed cluster analysis using variables of pain severity, psychosocial factors and pain coping strategies.
Results: Of 2088 participants, 309 (14.8%) reported CPP. CPP was significantly associated with being of reproductive age (Odds Ratios (OR) 2.43, 95% CI 1.69–3.48), multiple non-pain somatic symptoms (OR 3.58 95% CI 2.23–5.75), having fatigue (OR mild 1.74 95% CI 1.24–2.44, moderate/severe 1.82, 95% CI 1.25–2.63) and having depression (OR 1.61, 95% CI 1.09–2.38). CPP was less associated with multiple non-pain somatic symptoms in women of reproductive age compared to older women (interaction OR 0.51, 95% CI 0.28–0.92). We identified two clusters of CPP cases; those having little/no psychosocial distress and those having high psychosocial distress.
Conclusion: CPP is common in both age-groups, though women of reproductive age are more likely to report it. Heightened somatic awareness may be more strongly associated with CPP in older women. There are distinct groups of CPP cases characterised by the absence/presence of psychosocial distress.
Original languageEnglish
Pages (from-to)445–455
Number of pages11
JournalEuropean Journal of Pain
Issue number3
Early online date15 Sept 2016
Publication statusPublished - 1 Mar 2017

Bibliographical note

We are also grateful to Professor Krina Zondervan for providing the survey questionnaire of which chronic pelvic pain items was used in this study. We appreciate the members of the Epidemiology Group at the University of Aberdeen who assisted greatly with the questionnaire mailings. We are also grateful to those who worked on data entry: Yetunde Adelusi, Stephen McCall and Matthew Macfarlane. We are thankful to the women who participated in the survey.

Abimbola Ayorinde’s PhD funded by the Medical Research Council. This study was funded by the British Pain Society (Mildred Clulow Award) and preparatory work by National Health Service Grampian.


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