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Gynecology
Up to 10% of gynecology office consultations are for chronic pelvic pain (CPP)7,29. Chronic pain affects the sleep, performance and selfesteem. This leads to depression which, in turn, alters the neurotransmitter level in brain and thus leads to a greater experience of pain and lowers the threshold for pain.
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) causing frequent and painful bowel movements and pain with sex (dyspareunia).
As many as 60% of women experience dyspareunia30 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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