[Psychological treatment aspects of chronic pelvic pain in the woman]

Abstract

Pelvic pain is one of the most frequent disorders in gynecological practice often without clinical evidence. There are many underlying factors which contribute to this disorder, psychological as well as somatic. In the Department of Obstetrics and Gynecology at the University Hospital Graz, the diagnosis of chronic pelvic pain patients includes a medical as well as a psychological evaluation. According to the international diagnostic manuals pelvic pain is classified as a somatoform disorder. Our clinical experience shows that the majority of women with pelvic pain have a diagnosis of a somatoform pain disorder, which requires psychological interventions rather than medical. However, these patients usually undergo a variety of medical therapies, often without longterm success. These medically oriented treatments increase the patients' belief that the pain is of physical origin and not psychological, which is one of the greatest obstacles of psychological treatment. Chronic pelvic pain is a complex syndrome where medical and psychological diagnostic evaluation is essential. Psychological interventions can be performed at an earlier stage, in order to prevent the pain from becoming a chronic problem. The presence of psychologists within the Gynecology Department may help to establish a multidisciplinary treatment for these patients.