Causes of chronic pelvic pain in women are usually divided into gynaecological and non-gynaecological problems. This is mainly because of the dominant role of reproductive organs and the relation of pain to ovulation, menstruation and sexual activity. As well historically all female pelvic problems were referred to gynaecologists as they were more trained to perform pelvic examinations. However, this classification should not imply a smaller or trivial role for gastrointestinal, urological, musculoskeletal, myofascial or psychological problems which are equally important and need to be addressed. Accordingly, the gynaecologist who usually sees these patients first should be aware of the complexity of the issues involved and has to deal with them in a multidisciplinary approach. This is usually best done within a recognised team working closely with each other, using the same protocols and diagnostic means to reduce time wasting and repetitive investigations. The role of the nurse co-ordinator is vital in streamlining the group’s activity, organising time tables and cross consultations as well as tracing questionnaires and pain calendars. She or he would also act as the point of contact with the patients for information counselling as some patients identify better with nurses and could feel more comfortable in asking them more questions than they might do during the clinical interviews. This line of communication is the most important part in the jigsaw of the team performance.
In this manuscript the same classification of gynaecological and non-gynaecological causes would be used as it is easier for teaching purposes to subdivide them further into their subgroups for better understanding of the whole problem. However, clinically this classification might not be valid as patients with chronic pelvic pain usually present with symptoms related to more than one system and in many cases there might be no specific pathology to account for the pain at all.
