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Gynecology
Up to 10% of gynecology office consultations are for chronic pelvic pain (CPP). Chronic pain affects sleep, performance, and self-esteem. This leads to depression that, in turn, alters the neurotransmitter level in the brain and thus leads to a greater experience of pain by lowering the pain threshold.
Chronic pelvic pain can manifest as pain in the groin area and, in some patients, as pain over the perineum which includes coccydynia and tenosynovitis of ischial tuberosities. It may be associated with severe physical dysfunction in relation to voiding (dysuria), defecation (tenesmus with frequent and painful bowel movements), and pain with sex (dyspareunia).
As many as 60% of women experience dyspareunia when the term is broadly defined as pain during and after intercourse.
In the gynecology literature, few articles have been published about the significant incidence of myofascial (musculoskeletal) origin of chronic pelvic pain.
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