Pelvic Pain Assessment Research Updates: Episode 119 with Michelle Lyons

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.
• Review and reference the section on pelvic venous disorders in the vulvar pain module when assessing patients with post-coital pain, heaviness, or dragging sensation with prolonged standing.
• Consider the use of 3D anatomy models during patient education to facilitate understanding and empowerment.
• In the module, provide a detailed review of the physical exam, including tests for the abdominal wall (e.g., screening for hernias, Carnett's test).
• Emphasize the importance of a holistic, interdisciplinary, and patient-centered approach to goal setting and treatment planning for chronic pelvic pain patients.

Want to learn more? The updated Pelvic Pain Assessment module is live now - if you're already enrolled, you have access to it now, and if you'd like to join us to explore the new modules on assessment, vulvar pain and sexual health as well as the upcoming new and expanded module on endometriosis, bladder pain syndrome and pudendal neuralgia then visit CelebrateMuliebrity.com and join us before the price increases next month to reflect the extra content (for clarity, if you're already a student, you'll automatically get the upgrade!)