Clinical profiling of specific diagnostic subgroups of women with chronic pelvic pain

Lysia Demetriou, Michał Krassowski, Pedro Abreu‐Mendes, Kurtis Garbutt, Allison F. Vitonis, Elizabeth Wilkins, Lydia Coxon, Lars Arendt‐Nielsen, Qasim Aziz, Judy Birch, Andrew W. Horne, Anja Hoffman, Lone Hummelshøj, Claire E. Lunde, Jane Meijlink, Danielle Perro, Nilüfer Rahmioğlu, Kathryn L. Terry, Esther Pogatzki‐Zahn, Christine B. Sieberg, Rolf‐Detlef Treede, Christian M. Becker, Francisco Cruz, Stacey A. Missmer, Krina T. Zondervan, Jens Nagel, Katy Vincent
In: medRxiv · 2022 · doi:10.1101/2022.10.03.22280515 · W4301372476
preprint OA: green CC0 ⤵ 1 in-corpus citation
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This study characterized chronic pelvic pain subgroups, finding endometriosis-associated and comorbid groups reported higher pain intensity and impact on quality of life, particularly regarding dysmenorrhea and dyspareunia.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This paper studied women with chronic pelvic pain (CPP) to determine whether distinct diagnostic subgroups report different symptom profiles and different impacts of pain on quality of life, using a clinical profiling approach within a larger research program. The key finding reported in the abstract is that CPP subgroups can differ in their clinical presentation and in how pain affects quality of life, reflecting heterogeneity and frequent comorbidity. The authors note a major limitation that many women experience symptoms for years before diagnosis and/or treatment, which can complicate how subgroup differences are interpreted clinically. This paper is centrally about endometriosis — it was produced by an Oxford Endometriosis Centre–led team and specifically targets clinically defined CPP subgroups that include endometriosis as a key diagnostic context for pelvic pain.

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Abstract

Abstract Chronic pelvic pain (CPP) is a common condition affecting up to 26.6% of women, with many suffering for several years before diagnosis and/or treatment. Its clinical presentation is varied and there are frequently comorbid conditions both within and outside the pelvis. We aim to explore whether specific subgroups of women with CPP report different clinical symptoms and differing impact of pain on their quality of life (QoL). The study is part of the Translational Research in Pelvic Pain (TRiPP) project which is a cross-sectional observational cohort study. The study includes 769 female participants of reproductive age who completed an extensive set of questions derived from standardised WERF EPHect questionnaires. Within this population we defined a control group (reporting no pelvic pain, no bladder pain syndrome, and no endometriosis diagnosis, N=230) and four pain groups: endometriosis-associated pain (EAP, N=237), interstitial cystitis/bladder pain syndrome (BPS, N=72), comorbid endometriosis-associated pain and BPS (EABP, N=120), and pelvic pain only (PP, N=127). Clinical profiles of women with CPP (13-50 years old) show variability of clinical symptoms. The EAP and EABP groups scored higher than the PP group (p<0.001) on the pain intensity scales for non-cyclical pelvic pain and higher than both the BPS and PP groups (p<0.001) on the dysmenorrhoea scale. The EABP group also had significantly higher scores for dyspareunia (p<0.001), even though more than 50% of sexually active participants in each pain group reported interrupting and/or avoiding sexual intercourse due to pain in the last 12 months. Scores for the QoL questionnaire (SF-36) reveal that CPP patients had significantly lower QoL across all SF-36 subscales (p<0.001). Significant effects were also observed between the pain groups for pain interference with their work (p<0.001) and daily lives (p<0.001), with the EABP suffering more compared to the EAP and PP groups (p<0.001). Our results demonstrate the negative impact that chronic pain has on CPP patients’ QoL and reveal an increased negative impact of pain on the comorbid EABP group. Furthermore, it demonstrates the importance of dyspareunia in women with CPP. Overall, our results demonstrate the need for further exploration of interventions targeting QoL more broadly and suggest that novel approaches to classifying women with CPP are needed.

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Condition tags

endometriosischronic_pelvic_paindysmenorrheadyspareuniainterstitial_cystitis

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