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Pain in your underpants

By David Butler Science and the world 03 Mar 2015
David Butler, Pelvic Pain Foundation Australia Board Members Dr Susan Evans, Dr Meredith Craigie, Donna Benge, Tiffany Brooks and Kathy Allen, and Prof Mark Hutchinson


I was invited to a very special event last week – the launch of the Pelvic Pain Foundation of Australia, a not for profit body formed to promote education and research in the area of pelvic pain.

It was a pleasurable and emotional event – very multidisciplinary, with a number of politicians and members of community service organisations also attending.

Looking back over the years, we have always had a disproportionate amount of pelvic pain questions and calls for help directed to NOI – but have never really done anything specific about it. I spoke at the launch and apologised for a clinical life where if someone complained of pain in their underpants, I didn’t take it much further. And I guess most patients knew from bitter experiences that it was not worth complaining about, so in the undies it stayed. I came away from this foundation launch somewhat pensive – on current data there are almost 1 million men in Australia with chronic pelvic pain and no medical profession willing to take them on. That’s about 16 million in the US if we simply extrapolate the numbers. Recent work in the field has demonstrated that unacknowledged and painful periods in young teens have the potential to set them up for a life of chronic pain, yet on reflection, in the orthopaedic world we have known for decades that the severity of pain initially associated with an injury, and fear of further pain are important  predictors of chronicity. Why hasn’t this information been shared, applied, and young women educated and supported?

The launch emphasised the suffering in silence, the stigma, the avoidance of the issue by the health community, and the desperate need to address this issue scientifically.

I couldn’t help but think of the title to one of Carl Sagan’s books – “The Demon Haunted World – Science as a Candle in the Dark”. I borrowed Sagan’s quote in part of my talk, reflecting that pelvic pain has been in the dark for too long. However some brave people have been lighting candles for a while now, and organisations and movements like the Pelvic Pain Foundation of Australia can really make a difference.

Tell the world, and shine a light on the pelvis.


-David Butler



  1. It is surprising in this day and age that we are neglecting a body part representation in the brain. Are we not treating pain and suffering in what ever manifestation it presents. Where did the boundary slip in, where did the pelvis get left out?
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