Chronic pelvic pain is prolonged pain in a woman’s pelvic region (the area just below the belly button). The pain lasts months, usually three to six months. It is essential for women experiencing chronic pelvic pain to see a doctor in order to get an accurate diagnosis for the cause of their pain.
Chronic pelvic pain can be spread throughout the pelvic area or localized, radiating in a particular spot. It can be constant or intermittent, a dull aching pain or severe and sharp. The pain may arise when a woman sits or stands for long, during sex, or while urinating or during a bowel movement.
The pelvic area is home to several organs and tissues. As such, there can be several causes of chronic pelvic pain. One of the major causes is endometriosis. This is a disease where tissue similar to the tissue lining the inner uterus grows outside the uterus. The tissue breaks down during menstruation, clumping and irritating surrounding tissues and organs. This causes severe pain.
Adenomyosis is another possible reason for chronic pelvic pain. It also involves endometrial tissue but this time, the tissue grows within the muscle walls of the uterus. This causes heavy bleeding and pain.
Another possible cause of chronic pelvic pain is fibroids. These are non-cancerous growths within or outside the placenta. They cause feelings of heaviness or pressure in the pelvic area and can be painful.
Other causes of chronic pelvic pain are interstitial cystitis (a condition causing irritation and inflammation of the bladder walls), pelvic inflammatory disease (an infection of the reproductive organs often caused by sexually transmitted infections), and gastrointestinal conditions like irritable bowel syndrome. Bladder pain syndrome and pelvic floor prolapse can also cause pelvic pain. With the latter, the muscles forming the pelvic floor weaken, leading to pelvic pressure, discomfort, and pain.
A woman may experience chronic pelvic pain because they have one or more of the above conditions. Sometimes, the pain may even be a symptom of cervical or ovarian cancer. This is why it is absolutely crucial for women experiencing chronic pelvic pain to consult a physician as soon as they realize the pain is not going away.
To diagnose the cause of chronic pelvic pain, doctors recommend several tests, starting with a pelvic exam. This is where the physician touches the pelvic area and feels for abnormal stiffness or tenderness. They can also request blood tests to check for sexually transmitted infections or urine tests to check for urinary infections. Physicians may also request an ultrasound, magnetic resonance imaging (MRI). or computerized tomography scan (CT scan).
If these tests are inconclusive, the physician may recommend laparoscopy. This is a surgery whereby the surgeon makes a small incision in the pelvic area and inserts a tube with a tiny camera at the tip to enable them to examine the state of pelvic organs and tissues. This test can pinpoint diseases like chronic pelvic inflammatory disease and endometriosis.
When the physician identifies the disease causing the patient pain, they can confidently prescribe treatments for it. Depending on the disease, treatments include medication and surgery.
Sometimes though, doctors cannot accurately diagnose the cause of chronic pelvic pain, even after the patient has undergone all the tests. In these cases, doctors shift their focus to helping the patient manage their pain. They recommend medication such as muscle relaxers, pain relievers, and hormone treatments. They may also recommend therapies that relieve pain and discomfort in the pelvic area. These include physical therapy and massage. Counseling and alternative therapies like dry needling may also help.
