Prevalence and incidence of chronic pelvic pain in primary care: evidence from a national general practice database

K T Zondervan, P L Yudkin, M P Vessey, M G Dawes, D H Barlow, S H Kennedy
British Journal of Obstetrics and Gynaecology 1999, 106 (11): 1149-55

OBJECTIVES: To estimate the prevalence and incidence in primary care of chronic pelvic pain in women in the UK.

DESIGN: Cross-sectional analysis of MediPlus UK Primary Care Database.

SETTING: One hundred and thirty-six general practices in the UK.

POPULATION: From 284,162 women aged 12-70 who were registered on the database and who had a general practice contact in 1991, 24,053 chronic pelvic pain cases were identified between 1991 and 1995.

METHODS: Chronic pelvic pain was defined as pelvic pain lasting for at least six months, and cases were identified on the basis of contacts with general practice. Pain due to malignancy, chronic inflammatory bowel diseases or pregnancy, or which occurred only during menstruation or sexual intercourse, was excluded.

MAIN OUTCOME MEASURES: Prevalence and incidence rates of chronic pelvic pain in primary care by age and region.

RESULTS: Monthly prevalence and incidence rates of chronic pelvic pain were 21.5/1000 and 1.58/1000, respectively, with an annual prevalence of 38.3/1000. Monthly prevalence rates increased significantly with age (P < 0.001) from 18.2/1000 in 15-20 year olds to 27.6/1000 in women older than 60, as symptoms persisted longer in older women. Prevalence and incidence rates varied significantly between regions (P < 0.001), with the lowest monthly prevalence in Scotland (16.0/1000) and the highest in Wales (29.4/1000).

CONCLUSIONS: Chronic pelvic pain is a common condition in the UK, with a prevalence in primary care comparable to migraine, back pain, and asthma. Its prevalence in the general population is likely to be considerably higher.

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