Understanding and Addressing Gynecologic Procedural Pain

When beginning your next investigator-initiated application, consider the following NIH highlighted topic. The area of science described below is of interest to the listed NIH Institutes, Centers, and Offices (ICOs). This is not a notice of funding opportunity (NOFO).

Apply through an appropriate NIH Parent Funding Announcement or another broad NIH opportunity available on Grants.gov. Learn how to interpret and use Highlighted Topics.

Topic Description

Post Date: October 19, 2026

Expiration Date: October 19, 2028

Background:

Procedural pain is a significant and under-addressed concern in gynecologic care. Many common gynecologic procedures, including but not limited to pelvic exams, endometrial and cervical biopsies, intrauterine device (IUD) placement and removal, hysteroscopy, egg retrieval, and gynecologic surgeries such as hysterectomy, cesarean section, myomectomy, endometrial ablation, and endometriosis excision can cause substantial acute and persistent pain. Despite the prevalence of these procedures, standardized pain management approaches are limited, and the burden of procedural pain is not uniformly characterized across populations.

Gynecologic procedural pain disproportionately affects individuals who are already underserved by the healthcare system, including those with chronic pain conditions, a history of trauma, and/or limited access to care. There is growing recognition that inadequate pain control during and after gynecologic procedures may deter individuals from seeking recommended preventive care, delay diagnosis, and contribute to disparate health outcomes.

Gynecologic procedural pain may also have lasting consequences beyond the procedure itself, contributing to procedure avoidance, the development of chronic pelvic pain, the increased risk of opioid use disorder, and reduced engagement with reproductive and gynecologic care across the lifespan. Adolescents and young adults undergoing first-time procedures may be particularly affected, with implications for long-term care-seeking behavior.

Purpose:

This topic highlights NIH's interest in research that advances the understanding and management of gynecologic procedural pain to develop safe and effective pain treatment and prevention strategies.

  • Characterize the prevalence, severity, and variability of pain associated with gynecologic procedures across different populations
  • Identify biological, psychological, social, and structural factors that contribute to disparities in gynecologic procedural pain experience and management
  • Develop, validate, or refine safe and effective pharmacologic and non-pharmacologic interventions with emphasis on non-opioid therapeutics to prevent or reduce gynecologic procedural pain
  • Repurpose existing therapeutics for gynecologic procedural pain
  • Examine and optimize implementation strategies to improve the uptake of evidence-based, individualized pain management practices in gynecologic care settings
  • Identify risk factors and biologic and psychosocial mechanisms underlying the transition from acute gynecologic procedural pain to chronic pain
  • Develop pain prevention strategies to prevent acute gynecologic procedural pain and/or the transition from acute to chronic pain
  • Generate evidence to inform and strengthen clinical guidelines for pain assessment and management in gynecologic procedures, including in populations underrepresented in pain research 
This topic is being issued as part of the Make America Healthy Again initiative, which is expanding NIH and agency research into specific areas.

It aligns with:

  • Real World Data Platform (RWDP) : The NIH will link multiple datasets, such as claims information, electronic health records, and wearables data, into a single integrated dataset for researchers studying the causes of, and developing treatments for, the chronic disease crisis. The RWDP will eliminate redundancies from data collection, linkage, and compute infrastructures (including artificial intelligence (AI)/machine learning and high-throughput analytics) while maintaining rigorous privacy protections and consent protections. It will also dramatically reduce administrative overhead by relying on a unified set of data use and governance agreements.
  • Repurposed Drugs : The NIH and FDA will jointly investigate opportunities to strengthen the use of repurposed drugs for the treatment of chronic disease, while harmonizing authorization processes through collaborative clinical trial designs to achieve FDA approval.
  • Longitudinal Research for Chronic Disease Prevention : The NIH will leverage its extensive portfolio of longitudinal birth cohort data, including the Adolescent Brain Cognitive Development Study, Healthy Brain and Child Development Study, All of Us Research Program, and Environmental Influences on Child Health Outcomes Program to deepen our understanding of chronic disease at various stages of life by elucidating root causes, identifying modifiable risk factors, and uncovering effective prevention strategies. Examples of new research initiatives will include the importance of sleep and nutrition, health impacts of insulin resistance, potential health benefits of select high-quality supplements, and using fitness as a vital sign.
  • Mental Health and Addiction Research : The NIH, working with HHS, will strengthen existing research by directing funding for research on mental health and addiction, with a special focus on screentime use in children and adolescents.

Central Scientific Contact:
Gynecologic Health and Disease Branch
[email protected]

Participating ICOs

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Gynecologic procedural pain affects patient experience, adherence to preventive and diagnostic care, and downstream health outcomes. NICHD seeks investigator-initiated research on topics such as:
•    Epidemiology of gynecologic procedural pain burden across demographic, clinical, and geographic populations
•    Pharmacologic, behavioral, and/or structural individualized interventions to reduce gynecologic procedural pain and improve patient experience
•    Identification of risk factors for transitioning to chronic pain following gynecologic procedures and development of chronic pain prevention strategies
•    Implementation research to support adoption of evidence-based gynecologic pain management in clinical practice

NICHD’s participation reflects scientific interest in this area but does not indicate the availability of dedicated funds. Applicants should contact an NICHD program official prior to submission.

IC may give special consideration to support meritorious applications in this topic area.
ICO Scientific Contact:
Gynecologic Health and Disease Branch
[email protected]

Office of Behavioral and Social Sciences Research (OBSSR)
This office does not award grants. Applications must be relevant to the objectives of at least one of the participating Institutes or Centers listed in this topic.
ICO Scientific Contact:
Cathy Maulsby, PhD
[email protected]

For technical issues E-mail OER Webmaster