Prevalence of fibromyalgia in women with chronic pelvic pain: a systematic review and meta-analysis

Abstract

To evaluate the prevalence of Fibromyalgia (FM) in women with chronic pelvic pain (CPP) and to map the associated conditions that have been investigated. This review followed the International Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, with searches conducted across 8 databases, without time restrictions. Observational studies and clinical trials that included women aged ≥ 13 years with CPP and reported FM prevalence were included. Statistical analysis used a random-effects model in R software, with heterogeneity assessed through Cochran’s Q and Higgins’ I² statistics. Ten studies were included, encompassing 52,658 participants, predominantly from the United States, with cross-sectional designs and retrospective cohorts. The mean prevalence of FM was 10.3%, adjusted to 9.0% by the random-effects model, with high heterogeneity (I² = 91.4%). The prevalence range (2–16%) reflected differences in population, phenotype, and diagnostic methods. The available evidence suggests a potential overlap between fibromyalgia and chronic pelvic pain, particularly in some urological pelvic pain populations. However, substantial clinical and methodological heterogeneity limits the generalizability of these findings, which should be interpreted cautiously. The International Prospective Register of Systematic Reviews (PROSPERO): CRD420251142371.