Published in The Lancet Regional Health – Americas, a McMaster University study of nearly half a million people reveals that warning signs for chronic pelvic pain emerge years before formal diagnosis during adolescence, showing a 41 per cent higher rate of developing the debilitating condition among those with early gynecologic or reproductive health-care encounters.
Adolescent reproductive health issues increase long-term pelvic pain risk
- Early Indicators: Young people who seek care for adolescent reproductive health issues face a higher statistical probability of developing long-term pelvic pain later in life.
- Systemic Overlap: These adolescent encounters frequently coincide with concurrent gastrointestinal problems, mental health conditions, and chronic pain elsewhere in the body.
- Diagnostic Realities: Symptoms are frequently normalized as a standard part of growing up, delaying clinical intervention.
Population-Based Findings from McMaster University
Researchers utilized linked population-based health administrative data of nearly half a million Ontarians held at ICES to follow individuals from adolescence into adulthood. Among individuals who sought care for gynecologic or reproductive health problems as teenagers, 28 per cent experienced chronic pelvic pain (CPP) by 10 years into adulthood. This compared with about 15 per cent of individuals who had no such adolescent healthcare interactions. The association remained statistically significant even after researchers accounted for other health problems and healthcare use during the teenage years.
We asked a simple question: Were there signs, years earlier, that someone was on a path toward chronic pelvic pain? This study shows that indeed the gap between those affected by CPP was already visible early in adulthood and grew over time,
said lead author Shay Freger, a PhD candidate in McMaster’s Department of Obstetrics and Gynecology. The study was conducted with collaborators from ICES Toronto, the University of Toronto, and McGill University.
| Adolescent Health History | Adult CPP Prevalence (10 Years Post-Teen) | Relative Risk Increase |
|---|---|---|
| With Gynecologic/Reproductive Care Encounters | 28 per cent | 41 per cent higher rate |
| Without Reproductive Care Encounters | 15 per cent | Baseline cohort rate |
Chronic pelvic pain disrupts daily life and mental health
Up to one in four people assigned female at birth and gender-diverse people are affected by chronic pelvic pain, a debilitating condition. It is characterized by ongoing pain in the lower abdomen or pelvis that persists for months or years, significantly disrupting daily life, work, school, relationships, and mental health. Beyond reproductive concerns, the study found that adolescents with early healthcare encounters experienced elevated rates of gastrointestinal problems, mental health conditions, and chronic pain elsewhere in the body.
What is important about this study is that the warning signs were not limited to reproductive health alone. It suggests that adolescent menstrual and pelvic health may be part of a broader health picture that deserves earlier attention and more integrated care,
said senior author Mathew Leonardi, an associate professor in the Department of Obstetrics and Gynecology at McMaster University.
The research was funded by CanSAGE
Financial support for the study was provided by the Canadian Society for the Advancement of Gynecologic Excellence (CanSAGE) via their Early Career Investigator Grant.
References
- Freger, S. M., et al. (2026). Gynecologic and reproductive morbidity during adolescence and subsequent chronic pelvic pain in adulthood: a population-based matched cohort study. The Lancet Regional Health – Americas. DOI: 10.1016/j.lana.2026.101641
