UNC Center for Vulvar and Urogenital Pain

Chronic pelvic pain (CPP) is a common gynecologic complaint and one of the most common reasons women visit their gynecologists. It is defined as noncyclic, nonmenstrual pelvic pain persisting > 6 months, and located below the umbilicus.

This pain disorder affects approximately 15% of women in the United States and is responsible for up to 20% of gynecologic office visits and 15% of hysterectomies. It is not surprising that CPP is estimated to cost the health care system nearly 2 billion dollars per year.

The current evaluation and treatment of CPP includes a multidisciplinary approach secondary to the multifactorial nature of chronic pelvic pain. There is rarely a single identifiable cause and, despite the fact it is most likely to occur in women of reproductive age, it is estimated that only 30% of etiologies attributed to the development of chronic pelvic pain are gynecologic. Our clinic understands the many contributing factors to a presentation of pain disorders and we take the time necessary to evaluate previous records, speak with referring physicians, and take a thorough history of the pain problem. We investigate the possible contributions of all involved systems in the body, as well as the changes in the pain that may have occurred over time.

During the physical examination, we look carefully for contributions to the pain not usually detected by the routine pelvic examination, such as muscle spasms, trigger points, and subtle changes in pelvic structures. We bring long experience to the often difficult task of deciding what treatments are the best to use and when to use them.