The cost of chronic pelvic pain in women: a systematic review of the literature

Objectives Chronic pelvic pain affects 15%-20% of women and exerts an economic burden on patient and society. To systematically assess the literature to determine the costs related to chronic pelvic pain (CPP) for women. Methods The electronic databases MEDLINE, EMBASE, PubMed, and Cochrane Library were searched for studies published 1990-2019. Costs related to chronic pelvic pain symptoms (cyclical and acyclical pain, dysmenorrhea, dyspareunia, dysuria, dyschezia) were assessed. Results Of 1135 papers screened, 66 were screened in full-text, with a total of 13 studies included in final analysis. The majority was based in North America (n=8), and others (n=1 each) from Australia, Germany, Japan, Taiwan, and UK. Study designs included cross-sectional (n=6), retrospective and prospective cohort (n=6), and randomized controlled trial (n=1). Costs were categorized into healthcare (n=13), out-of-pocket (n=5), productivity loss (n=5), and total (n=6). Estimated healthcare costs ranged from $1,367 to $7,043 per woman per year (USD). The out-of-pocket costs ranged from $193 to $2,457 per woman per year. Productivity loss ranged from $4,216 to $12,789 per woman per year. Total costs ranged from $1,820 to $20,898 per woman per year. The yearly costs of CPP varied according to the country: yearly total costs were estimated to be $2.8 billion/year, ¥191,680 to ¥246,488 per woman per year, and $16,970 to $20,898 per woman per year in the US, Japan, and Australia respectively. Conclusions The literature suggests that chronic pelvic pain represents a considerable economic burden on women and healthcare systems worldwide, with productivity loss contributing a substantial portion of total costs.