Psychological aspects of chronic pelvic pain

Chronic pelvic pain (CPP) is a common gynecological problem which is poorly understood. A physical cause for the pain often cannot be established and, consequently, it has been difficult to treat successfully. In the absence of an identifiable physical cause for pain, researchers have attempted to identify a psychopathological causation. Associations have been reported between CPP and factors including personality and mood disturbance, childhood events, particularly sexual abuse, and sexual and relationship difficulties. However, evidence that women with CPP without discernible pathology differ in personality, psychological state, or life experiences from women with an identifiable cause for the pain, or those without chronic pelvic pain, is inconclusive. This review highlights methodological flaws inherent in many of the studies. It suggests areas and approaches for future research adopting a broader biopsychosocial perspective, which may generate findings of greater clinical utility.