Chronic Pelvic Pain Prevalence Increases Across Categories of Temporomandibular Disorder Severity in Women: A Large Cross-Sectional Study.

Objectives: Temporomandibular disorders (TMD) and chronic pelvic pain (CPP) are recognized as chronic overlapping pain conditions that frequently affect women. However, evidence regarding how CPP prevalence varies across categories of TMD symptom severity remains limited. This study investigated whether greater TMD symptom severity was associated with a higher prevalence of CPP in adult women. Methods: This cross-sectional study included 790 women aged 18-65 years. TMD symptom severity was assessed using the Fonseca Anamnestic Index, and CPP was defined as selfreported pelvic pain lasting at least six months. Anxiety symptoms and physical activity were evaluated using the Beck Anxiety Inventory and the International Physical Activity Questionnaire. Sociodemographic and clinical variables were also collected. Group comparisons were performed using chi-square and ANOVA tests, and relative risks (RR) with 95% confidence intervals were estimated. Results: Greater TMD symptom severity was associated with a higher prevalence of CPP (p < .001). Compared with women without TMD, those with mild TMD had a higher prevalence of CPP (RR = 2.05, 95% CI 1.21-3.48), whereas women with moderate and severe TMD showed nearly fourfold higher prevalence (RR = 3.81, 95% CI 2.30-6.32 and RR = 4.00, 95% CI 2.37-6.75, respectively). Women presenting both conditions also showed a higher prevalence of anxiety symptoms, urinary complaints, and medical comorbidities. Discussion: Higher TMD symptom severity was associated with a higher prevalence of CPP in adult women, supporting the presence of overlapping pain conditions. These findings reinforce the importance of integrated and multidimensional approaches in the assessment of women with chronic pain.