brand logo

Am Fam Physician. 2025;111(3):218-229

This clinical content conforms to AAFP criteria for CME.

Author disclosure: No relevant financial relationships.

Chronic pelvic pain affects up to 26% of individuals with female anatomy and is defined as at least 6 months of pain that is perceived to originate in the pelvis. Chronic pelvic pain is highly correlated with psychosocial comorbidities, including depression, anxiety, and history of abuse. Although common causes include irritable bowel syndrome, bladder pain syndrome (interstitial cystitis), pelvic floor dysfunction, and endometriosis, chronic pelvic pain is most often the result of multiple coexisting pain conditions and central nervous system hypersensitivity. Evaluation requires a biopsychosocial approach, beginning with a complete history and physical examination to ensure an accurate and timely diagnosis. Diagnostic laboratory and imaging tests are of limited utility and should be tailored to investigate presenting symptoms and examination findings. When a single etiology is identified, treatment should follow disease-specific guidelines; otherwise, the management of undifferentiated chronic pelvic pain should follow an interdisciplinary approach to improve function and quality of life. Multimodal treatment includes pain education, self-care, behavioral therapy, physical therapy, and pharmacotherapy, with limited indications for surgical interventions. Regular follow-up to review progress is necessary. Clinicians should have a low threshold for referral to interdisciplinary pain management or other subspecialties when improvement is not seen.

Chronic pelvic pain (CPP) in individuals with female anatomy is defined as at least 6 months of pain that is perceived to originate in the pelvis. Previously, the condition included only noncyclic pain, but the current definition also includes cyclic pain when symptoms have cognitive, behavioral, sexual, or emotional effects.1 CPP has been shown to lead to decreased productivity, poor emotional well-being, and sexual and relationship dysfunction, making early recognition and prompt evaluation and treatment essential to maintain or restore quality of life.2

Already a member/subscriber?  Log In

Subscribe

From $165
  • Immediate, unlimited access to all AFP content
  • More than 130 CME credits/year
  • AAFP app access
  • Print delivery available
Subscribe

Issue Access

$59.95
  • Immediate, unlimited access to this issue's content
  • CME credits
  • AAFP app access
  • Print delivery available

Article Only

$34.95
  • Immediate, unlimited access to just this article
  • CME credits
  • AAFP app access
  • Print delivery available
Purchase Access:  Learn More

Continue Reading

More in AFP

More in PubMed

Copyright © 2025 by the American Academy of Family Physicians.

This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.  See permissions for copyright questions and/or permission requests.