The lowdown on a new international pelvic pain statement and classifcation system
A quick roundup of the new joint
FIGO and IPPS pelvic pain statement
& classification system
Two new papers have just been published by a collaboration between FIGO (the International Federation of Gynaecology and Obstetrics) and the International Pelvic Pain Society (IPPS – mostly US-based medics working in pelvic pain). The first is a consensus statement on the big challenges affecting pelvic pain care worldwide(Villegas-Echeverri et al., 2025). They describe chronic pelvic pain (CPP) as an “invisible epidemic”. It affects roughly one in four women globally, yet remains under-recognised, under-researched, and under-treated.
For us as physios, this paper feels like a validation of the way we already work: multidimensional, biopsychosocial, and patient-centred. It reinforces the importance of education and empowerment, not only our work in helping women understand their pain, but also supporting them to navigate healthcare systems that can sometimes feel overwhelming or dismissive.
It’s also encouraging to see the American pelvic pain body aligning with Canadian and other international organisations in calling for more nuanced, holistic models of care. The shift in tone is noticeable, it’s less about “fixing lesions/disease” and more about recognising the complex interplay of biology, psychology, and social context.
My key takeaways
Clearer definitions, please. At the moment, CPP definitions vary (ACOG, IASP, RCOG, WHO). Is it 3 months or 6? A condition in its own right, or just a symptom? This inconsistency causes confusion. A global definition would help clinicians communicate better and, crucially, validate patients’ experiences.
Inequality in care is real. Delays of 4–11 years for an endometriosis diagnosis are still common. Women from underserved or minority backgrounds are less likely to access pain management or specialist referral. We need better diagnostic models and fairer pathways.
Biopsychosocial is not optional. The statement strongly pushes for transdisciplinary, trauma-informed care across the MDT. For physios, that means embracing collaboration and recognising the wider drivers of pain.
Education gaps remain huge. Many healthcare providers still lack training in CPP. Physiotherapists who specialise in pelvic pain are in a prime position to share knowledge, support colleagues, and advocate for joined-up care.
Empowerment matters. Validating women’s experiences, reducing stigma, and providing clear, accessible education can make a real difference. Physios often lead the way in these conversations, helping women feel heard and supported in their rehab journey.
FIGO and IPPS are calling loudly and clearly for universal access to quality care for all women with CPP. For those of us in pelvic health, it’s heartening to see international bodies championing the very approaches we value; holistic care, patient empowerment, and collaboration across disciplines. Hurrah!
The second paper is a new classification system for CPP: “R U MOVVING SOMe” (Lamvu et al., 2025)
The acronym covers 12 categories of conditions associated with CPP:
R – Reproductive (e.g. endometriosis, adenomyosis)
U – Urinary (e.g. bladder pain syndrome, urethral syndrome)
M – Musculoskeletal (e.g. pelvic floor overactivity, joint dysfunction)
O – Other (not otherwise classified, e.g. adhesions, hernias)
V – Vulvovaginal (e.g. vulvodynia, dermatological causes)
V – Vascular (e.g. pelvic congestion syndrome)
I – Idiopathic (no identifiable cause despite full work-up)
N – Neurologic (e.g. pudendal neuralgia, neuropathies)
G – Gastrointestinal (e.g. IBS, IBD)
S – Sensitization / nociplastic pain (altered central pain processing)
O – Overlapping pain conditions (e.g. fibromyalgia, migraines, chronic fatigue)
Me – Mental health (e.g. anxiety, depression, trauma-related disorders)
At first glance, this new system feels a bit like a repetition of what we already do in pelvic health physiotherapy: it’s essentially a biopsychosocial lens for looking at pelvic pain. That’s not new to us, though interestingly the “social” aspect isn’t strongly emphasised here. From a clinical perspective, it also feels a little cumbersome, lots of boxes to tick, lots of labels to apply. The system does allow for multiple categories per patient, which is realistic given that CPP rarely has a single cause. But it also risks creating more variation in diagnostic terminology, which is the very thing the first consensus paper was trying to simplify. For example, one patient might end up being classified as CPP-R (endometriosis) + CPP-G (IBS) + CPP-Me (anxiety).
That said, it’s important to keep the context in mind. This framework was designed to do what the “PALM-COEIN” acronym did for abnormal uterine bleeding; provide a shared language that validatespatients’ experiences and helps clinicians organise care. And coming from a strongly biomedical system where musculoskeletal and psychological contributions to pain are often overlooked, this is actually a significant step forward. For many American gynaecologists, it could mark a cultural shift towards a more holistic, patient-centred way of thinking about CPP.
For us in the UK, and perhaps for physiotherapy more broadly, I don’t think this will change clinical practice much. The EAU guidelines already give us a simpler and more practical diagnostic framework, and day-to-day we continue to work holistically with patients in a biopsychosocial way. Still, it’s worth keeping an eye on these international developments as they show where the wider field is moving, and they may shape how the next generation of doctors approach women with chronic pelvic pain.
References
Villegas‐Echeverri, J.D., Robert, M., Carrillo, J.F., Green, I., Meinhold‐Heerlein, I., Attar, R., Pope, R. and Lamvu, G., 2025. FIGO–IPPS consensus statement: Addressing the global unmet needs of women with chronic pelvic pain. International Journal of Gynecology & Obstetrics, 169(3), pp.1140-1145.
Lamvu, G., Villegas‐Echeverri, J.D., Allaire, C., As‐Sanie, S., Carrillo, J., Khalil, S., Horne, A.W., Wang, A. and Munro, M.G., 2025. Developing the FIGO‐IPPS “RU MOVVING SOMe” classification system for female chronic pelvic pain. International Journal of Gynecology & Obstetrics.
