Chronic pelvic pain in women

Many conditions in chronic pelvic pain are controllable but not curable. Most have a relapsing-remitting course and may require a lifetime of treatment.

Some gynecologic conditions, such as fibroids, adenomyosis, or endometriosis, can be definitively managed with extirpative surgery. This is not an option for other associated conditions such as interstitial cystitis, irritable bowel syndrome, and fibromyalgia. These diseases frequently follow a relapsing-remitting course with variable response at any one time to any particular treatment. Stress from life events will usually precipitate a flare of symptoms.

Patients may still have pain following definitive surgery due to other, undiagnosed, pain generators. Some patients have a brain predisposed to pain perception, and when all pain generators are optimally managed, they may present with a new pain in a different area, such as the low back, or leg.