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A new McMaster University study of nearly half a million people has found that many people who go on to develop chronic pelvic pain (CPP) may have been showing warning signs years before diagnosis, offering a potential opportunity to identify people at increased risk earlier in life.

One of the most significant findings of the study, which was published in The Lancet Regional Health—Americas on Oct. 6, 2026, was that by 10 years into adulthood, CPP affected 28% of those who had sought care for gynecologic or reproductive health problems as teenagers, compared with about 15% of those who had not. The association remained even after accounting for other health problems and health care use during adolescence.

Furthermore, the rate of developing CPP was 41% higher among those with earlier gynecologic or reproductive health care encounters.

"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," says lead author Shay Freger, a Ph.D. candidate with McMaster's Department of Obstetrics and Gynecology.

To conduct the study, researchers used linked population-based health administrative data on nearly half a million Ontarians held at ICES, following those individuals through adolescence into adulthood. The study was conducted with collaborators from ICES Toronto, the University of Toronto and McGill University.

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