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The Initial Management of Chronic Pelvic Pain (Green-top Guideline No. 41)

Summary: Chronic pelvic pain can be defined as intermittent or constant pain in the lower abdomen or pelvis of a woman of at least 6 months in duration, not occurring exclusively with menstruation or intercourse and not associated with pregnancy. It is a symptom not a diagnosis. Chronic pelvic pain presents in primary care as frequently as migraine or low-back pain and may significantly impact on a woman’s ability to function. Living with any chronic pain carries a heavy economic and social burden.

Aiming for accurate diagnosis and effective management from the first presentation may help to reduce the disruption of the woman’s life and may avoid an endless succession of referrals, investigations and operations. This guideline provides an evidence-based framework for the initial assessment of women with chronic pelvic pain. It is intended for the general gynaecologist but may be of use to the general practitioner in deciding when to refer and to whom.

COVID disclaimer: This guideline developed as part of the regular programme of Green-top Guidelines, as outlined in our document Developing a Green-top Guideline: Guidance for developers (PDF), and prior to the emergence of COVID-19.

Version history: This is the second edition of this guideline; the third edition is currently in development.

Developer declaration of interests: Available on request.

This page was last reviewed 23 May 2012.