Chronic Pelvic Pain

Pelvic pain in women effects the lower part of the pelvis and abdomen. Pelvic pain is usually characterized by a wide spread pain from below the bellybutton to between the hips that can last six months or longer. Chronic pelvic pain can either be a symptom of another disease or condition, or it can be a condition by itself. Chronic pelvic pain has many different symptoms of pain such as a dull aching, sharp pains and cramping, severe and steady pain, intermittent pain that comes and goes, and pressure and heaviness deep within the pelvis.

Alongside this pelvic pain, patients may also experience pain when they sit for a long period of time, stand for a long period of time, have sexual intercourse, have a bowel movement, or urinating. The chronic pelvic pain can range from a mild and annoying pain to a severe and debilitating pain that can disrupt sleep, exercise, work, and other daily activities.

Sometimes, chronic pelvic pain may develop without a source or cause. Chronic pelvic pain may be associated with many other conditions and diseases. Other times, these conditions may be the source for one's chronic pelvic pain. Conditions that are associated with chronic pelvic pain include:

  • endometriosis- a condition in which the tissue from the lining of the uterus grows outside of the uterus.

  • tension in the pelvic floor muscles- pain can come from tension and spasm of the pelvic floor.

  • chronic pelvic inflammatory disease- this condition is usually sexually transmitted and cause scarring of the pelvic nerves.

  • ovarian remnant- remaining pieces of an ovary after a hysterectomy may develop into painful cysts.

  • Fibroid- these growths in the uterus are not cancerous, but will create pressure in the pelvic region.

  • irritable bowel syndrome- a possible symptom of this condition can be pelvic pain.

  • painful bladder syndrome (interstitial cystitis)- those with this condition may experience pelvic pain as the bladder fills, and feel relief after urination.

  • pelvic congestion syndrome- enlarged nerves may cause pain.

  • psychological factors- such as chronic stress, emotional distress, and depression can cause an increase in pelvic pain.

When a doctor is diagnosing chronic pelvic pain, he or she will need a personal health history, family history, and a list of symptoms to eliminate the many conditions that involves chronic pelvic pain. Some other exams and tests that can be administered include an ultrasound, a culture from the vagina or cervix, a pelvic exam, a laparoscopy, and other imaging tests such as X-rays, CTs, and MRI. The diagnosis process can be a long process, and for certain people, a source for this pain may never be found. If a cause for this chronic pain can be discovered, then the treatment will focus on eliminating the cause. But if the physician cannot find the cause, then the treatment will focus on managing the pain.

Medications that may be given to manage chronic pelvic pain include pain relievers (either over the counter or prescription), hormone treatments, antibiotics, and antidepressants.

Doctors may also recommend physical therapy, neurostimulation, trigger point injections, relaxation techniques, acupuncture, and psychological counseling. Surgery may also be an option if the doctor finds that it is necessary to treat the underlying problem. Surgical procedures that are done to treat chronic pelvic pain and its associated medical condition such as a laparoscopic surgery that removes endometrial tissue or a hysterectomy and bilateral oophorectomy that removes the uterus and ovaries.There are many things you can do at home in order to manage chronic pelvic pain. Because anxiety and stress can increase the pain, stress management techniques can be done to reduce stress triggered pain. These techniques can be easily incorporated into daily life. Stress management strategies include simple deep breathing, exercising, increasing physical activity, practicing meditation, and getting an adequate amount of sleep.

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