© PR MICHEL CANIS, ISM/SPL. Endometrotic lesions of the fallopian tube.

Chronic pelvic pain linked to significant personal and economic cost

By Bianca Nogrady
Chronic pelvic pain is associated with significant economic costs in lost productivity, according to an Australian study published in PLoS ONE.

A survey of 407 women with either a confirmed diagnosis of endometriosis or chronic pelvic pain without a diagnosis of endometriosis found chronic pelvic pain was associated with a cost of A$24,912 to A$30,679 (Int$16,970 to $20,898) per woman per year, regardless of whether there was a formal diagnosis of endometriosis, most of which was due to productivity loss.

Women with endometriosis faced an average of A$3876 (Int$2640) per year for total health costs, A$25,665 (about Int$17,484) for productivity costs and A$1136 (Int$774) for carer costs. For those with chronic pelvic pain but without an endometriosis diagnosis, the average annual costs were A$4719 (Int$3215) for total health costs, A$18,773 (Int$12,789) for productivity costs and A$1418 (Int$966) for carer costs.

There was a significant direct association between pain scores and overall cost, with a six-fold increase in overall cost from minimal pain to severe pain, but a 12.5-fold increase in productivity costs.

Study coauthor Professor Jason Abbott from the School of Women’s and Children’s Health at UNSW Sydney said the cost impact of chronic pelvic pain on women had not really been explored, despite so many patients feeling it was an issue for them.

‘For too long we have normalised women’s pelvic pain and their symptoms, without actually recognising that there are very substantial and serious long term health, social and financial implications for these diseases,’ said Professor Abbott, who is also Medical Director of Endometriosis Australia.

He told Medicine Today that the association between pain levels and cost suggested that symptom relief and quality of life were far more important treatment goals.

‘We could remove the disease, but if you still have substantial pain, or have a recurrence of those symptoms, then that has a debilitating effect on quality of life,’ he said.

The study also found the total economic burden per year in Australia of chronic pelvic pain in the reproductive aged population was A$9.5 billion (Int$6.5 billion).

‘We are dealing with young women at the prime of their life, so taking them out of productivity, out of study, out of work, has a knock-on effect to their own productivity and the economic worth in the long term.’
PLoS ONE 2019; https://doi.org/10.1371/journal.pone.0223316.