Chronic Pelvic Pain: a Neuropsychiatric View of the Gynecological Problem

Chronic pelvic pain (CPP) in women is a multifactorial problem that requires an interdisciplinary approach involving the teamwork of an obstetrician-gynecologist and related specialists. In 80% of patients the causes of CPP are inorganic, while 40% of diagnostic laparoscopic operations and 12% of hysterectomies are performed annually. Pathogenetic reactions triggering CPP syndrome include increased anxiety, neurosis and concomitant high levels of stress. A cascade of such reactions leads to the formation of a vicious circle. CPP directly affects the social life of women. About 15% of women with CPP cannot work, and 45% have a noticeable decrease in productivity. Treatment of the psychoemotional component of CPP is a priority task of an obstetrician-gynecologist.