Psychological aspects of the management of chronic pelvic pain

This article outlines the main psychological issues involved in the management of chronic pelvic pain. It argues for an integrated process of care that acknowledges the role of psychological factors in all experiences of pain and attempts to help the patient to understand this from the inception of care. Issues at each level in the process of care, through seeking help and primary and secondary care, are systematically considered, and guidance is provided on when more specific psychological input may be needed. The emphasis is on psychological aspects of management by all staff throughout the process so that women do not feel that their distress is marginalised. The importance of pre-existing beliefs, women's need for an acknowledgement of the reality of their distress, how to provide information and effective reassurance are discussed. Issues to consider in terms of mood, the role of sexual abuse and the influence of chronic pelvic pain on relationships are included, together with ideas about specific psychological approaches that can be of benefit.