The first consultation of a patient with chronic pelvic pain

Reading the literature about chronic pelvic pain it is noticed that this condition is often mentioned as being complex and difficult to treat. Pelvic pain patients have a reputation of being dissatisfied, wanting more and visiting your office regularly. This article highlights the background of the consultation process and the consecutive helping ideas in approaching a patient that is referred to you with chronic pelvic pain. Attention is paid to basic attitude at the start, patient expectations, language used, requesting diagnostics and making a therapy plan. All applied to the first consultation with your patient. Special attention will be given to placebo and nocebo effects of the words used in the conversation. Furthermore the communication about what and why for diagnostics and referrals is discussed. Many practical tips and helping ideas are presented to improve the joy of working with patients presenting with this interesting complaint. • Chronic pelvic pain patients are a challenging group to work with. • Patient expectations play a decisive role in the outcome of treatment. • Knowledge of pain and its mechanisms makes talking more efficient. • Optimizing placebo and minimizing nocebo increase treatment effectiveness. • Diagnostics needs an understandable and motivated explanation.