 Some studies suggest that around a quarter of women experience or have experienced persistent pelvic pain. In this video, we're going to look further into that condition to understand one tiny bit more of what those people, what maybe one eighth of the entire world are going through. The pain experience is complicated here by the nature of its location, is bound up with questions of fertility of sexual dysfunction. The person with it may be disabled by pain, but may find it hard to be honest about, even with friends and family, much less health professionals. Without the ability to communicate and share, people can become isolated in their pain experience, increasing their distress, which goes on to worsen the pain. As with all forms of chronic pain, we can think about PPP in terms of four qualities. One, the intrinsic organ derives pain, and for women, this might include period pain, irritable bowel syndrome, pelvic muscle spasm, vulval pain, endometriosis, bladder issues, budendal neuralgia, premenstrual symptoms, the list goes on. This is why it can be so hard to work out the cause and not to mention frustrating for people who are looking for one. Number two, the response from our muscles to this pain. A useful analogy here is in lower back pain from a bulging disc. The disc itself causes initial injury. The cramping of the surrounding muscles in response to the injury contributes significantly to the overall burden of pain. Three, nerve pathway central sensitization. In simple terms, this means a heightened pain experience due to physical changes at a neuronal level, a fault in the way the brain processes pain. People with central sensitization of nerve pathways experience more pain as a result of injury. The cruel irony is that chronic pain conditions can cause this central sensitization. Number four, the ongoing psychosocial impacts. As we touched on briefly, chronic pain can lead to isolation. You might not be able to continue your job or do your favorite hobbies, and this is crucial to the understanding and treatment of chronic pain, as if we are not in a good place mentally, we are less capable of coping with our pain condition. In that last category, extends into the sex lives of people with PPP and from that, intimate relationships in general. An adolescent with PPP may not feel comfortable to get into a relationship for fear of what may result. So yes, it's hard, but that doesn't mean it can't get better. A range of treatment options exist beyond the scope of this video. Some lie in the hands of the patient, some in the hands of the treating team. Importantly, the earlier the problem is picked up, the better the person's outcomes will be. It's critical to step in before the negative spiral picks up strength. Sadly, however, one of the main complaints you'll hear from people with the condition is that they've faced interminable delays in the recognition and diagnosis of their condition. So in order for us to catch it early, some change needs to happen. Current recommendations include better education on the topic, through medical schools, doctor training programs as well as through the community in general. Better research, better guidelines for treatment, and less stigma. To quote the Pelvic Pain Report, which was written in 2011 by a group of determined doctors and community advocates, this condition has copped considerable stigmatization and neglect with resulting disastrous effects on women and young girls. I'd recommend reading the report and I'll put a link in the description below. Thanks for watching, and we will see you next time.