Health care utilization among women with chronic pelvic pain

OBJECTIVE: This study aimed (i) to examine symptom burden, health care use, perceived treatment effectiveness and experiences of trivialization among women with chronic pelvic pain (CPP), and (ii) to identify predictors of the number of physician visits and sick days. DESIGN AND SETTING: Cross-sectional online survey among 1204 women aged ≥18 years reporting CPP for ≥6 months. METHOD: Data were collected via a self-administered questionnaire assessing CPP-related symptoms, illnesses, comorbidities, consulted specialists, perceived symptom trivialization by physicians, perceived treatment effectiveness and CPP-related sick days. Poisson regression and negative binomial regression were performed to identify predictors of the number of consulted specialists and of the number of sick days, respectively. RESULTS: Among the study population, 70.60% (n = 850) reported endometriosis, 63.63% (n = 766) reported to have consulted more than five physicians, and 79.90% (n = 962) reported trivialization experiences. Trivialization and perceived improvement through both pharmaceutical and non-pharmaceutical treatments were associated with a higher number of specialist consultations (incident rate ratios [IRRs] = 1.21, 1.26, ps < 0.001). Among women reporting sick days, trivialization (IRR = 1.20, p < 0.041) and perceived improvement through both treatments (IRR = 1.69, p < 0.001) were related to a higher number of sick days among those with at least one sick day. CONCLUSION: Experiences of trivialization and greater perceived treatment improvement were associated with a higher number of CPP-related sick days and specialist consultations, emphasizing the need to take CPP seriously from the first consultation.