Identification of diagnostic subtypes of chronic pelvic pain and how subtypes differ in health status and trauma history

OBJECTIVE: Our primary aim was to identify subtypes of chronic pelvic pain and to compare the cases of women with the identified subtypes on health status and trauma history. We hypothesized that women with diffuse abdominal/pelvic pain would have greater health impairment and report more lifetime trauma than women with vulvovaginal pain or cyclic pain. STUDY DESIGN: We collected questionnaire data on 289 consecutive women patients from a university chronic pelvic pain clinic. From patient records, 1 gynecologist identified chronic pelvic pain subtypes on the basis of reported symptoms and the localization of pain during examination. We used analysis of covariance with pairwise contrasts. RESULTS: Seven diagnostic subtypes were identified. Patients with diffuse abdominal/pelvic pain had more trauma and worse mental and physical health status compared with patients with vulvovaginal pain and cyclic pain. Those patients with abdominal/pelvic pain also had poorer health than patients with neuropathic and fibroid pain. Endometriosis was unrelated to health status. CONCLUSION: There is immense need for further research to define subtypes of chronic pelvic pain.