A Different Way to Think About Chronic Pelvic Pain

Chronic pelvic pain (CPP), experienced by as many as 20% of reproductive-age women, can be challenging to treat. Presence of CPP does not necessarily correlate with underlying pathology, such as endometriosis — and when endometriosis is identified, medical or surgical treatment may not alleviate the pain. Central nervous system amplification of pain processing, a factor in many chronic pain syndromes, might underlie pain perception in at least some women with CPP. In a quantitative test of pressure-pain sensitivity at a nonpelvic site (the nondominant thumbnail), researchers compared responses of 114 women with CPP or surgically confirmed endometriosis or both (35 with painless endometriosis, 15 with endometriosis and dysmenorrhea, 42 with …