Episode Details

Hello & welcome to this episode, where I thought it might be good to see out the end of Pelvic Pain Awareness month with an extract from my new Female Pelvic Pain online course updates to share some great articles from 2026 that I think are moving the conversation forward.

We start with an overview of female pelvic pain assessment, focusing on evidence-based assessment frameworks and clinical strategies. I'm exploring a key research paper from 2026 by As Sanie et al. on chronic pelvic pain evaluation, which recommends an organ-system-based approach considering gynecologic, gastrointestinal, musculoskeletal, urologic, neurologic, and vascular sources, and we'll also explore the 2026 EAU Guidelines in the course conten

I do emphasise the importance of trauma-informed care, including creating safe environments, obtaining ongoing consent, and validating patient experiences.

I've outlined a comprehensive assessment protocol in the course updates, covering external physical examination of the pelvic floor, vulvar structures, and abdominal wall, incorporating strategies to check for issues like hernia and ACNES, the importance of Carnett's test, along with the use of patient-reported outcome measures like the Central Sensitization Inventory and Pain Catastrophizing Scale.

The discussion also highlights the need to address nociplastic pain mechanisms, central sensitization, and the interplay between peripheral pathology and central pain amplification in chronic pelvic pain management.

Some of the talking points:

• Review and utilize the VAMP protocol in the vulvar pain module for assessment of vulvar, anorectal, musculoskeletal/myofascial, and perineal/periurethral structures in relevant patients.
• Ensure inclusion of trauma-informed care principles in all patient interactions, including ongoing consent, patient-led goal setting, and environmental safety considerations.
• Screen patients for risk factors and comorbidities such as obesity, physical inactivity, depression, anxiety, sleep disturbance, ACEs, and genetic/epigenetic factors as part of the pelvic pain assessment.
• Use and recommend appropriate patient-reported outcome measures (e.g., Central Sensitization Inventory, Pain Catastrophizing Scale, DAS, PSEQ, Tampa Kinesiophobia Scale) to guide treatment planning and monitor progress.
• Encourage the use of bowel and bladder diaries to identify patterns and connections between symptoms and lifestyle factors in patients with chronic pelvic pain.
• Provide pain neuroscience education to patients, emphasizing the role of central sensitization and the importance of addressing inflammatory load through sleep, stress management, and non-nociceptive movement.<