Pain management strategies and their associations with quality of life and pain interference in women with chronic pelvic pain: A cross-sectional survey

Background Chronic pelvic pain (CPP) affects an estimated 6-27% of women and is associated with substantial impairment in quality of life (QoL). Common conditions include endometriosis, vulvodynia, and interstitial cystitis. Management typically involves multiple biomedical and psychological strategies, often used in combination, yet their independent associations with QoL and pain interference remain unclear. Objectives To examine associations between six pain management strategies (surgery, hormonal medication, non-hormonal medications/therapies, analgesia, alternative therapies, and psychological therapy) and World Health Organization Quality of Life (WHOQOL-BREF) domains, and pain interference in women with CPP. Design Cross-sectional survey study. Methods Women with CPP (N = 147) completed an online questionnaire. Outcomes included WHOQOL-BREF Physical, Psychological, Social, and Environment domains, global QoL, and pain interference. Multiple linear regression models examined associations with QoL domains and pain interference, adjusting for simultaneous strategy use. Ordinal logistic regression examined global quality of life. Results Surgery was associated with lower Physical QoL (p = .007). Analgesia was associated with poorer Physical (p = .033), Psychological (p = .022), and Environmental quality of life (p = .041). Psychological therapy was associated with higher Psychological (p = .037) and Environment QoL (p = .023). Use of non-hormonal medications/therapies was associated with greater pain interference (p = .016). No clear associations were observed for Social QoL or global QoL. Conclusion Overall patterns are consistent with a biopsychosocial understanding of CPP. Surgery and analgesia were associated with lower QoL in selected domains, which may reflect greater symptom severity, treatment complexity, or confounding by indication. Psychological therapy was associated with higher psychological and environmental QoL while non-hormonal medications/therapies suggested greater pain interference. Findings suggest earlier integration of psychological care, regular review of analgesic use, and routine monitoring of quality of life and pain interference within multidisciplinary CPP pathways. Causal inferences are limited by the cross-sectional design.