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Care for WOMEN by WOMEN

Chronic Pelvic Pain

Chronic pelvic pain (CPP) is a continuous pain in the lower abdomen region or the pelvis. About one in six women are affected by CPP, with more frequent occurrence in the women of childbearing age. No two women with CPP have same experience of pain.

Causes of Pelvic Pain

Causes of CPP may be summarised as below

Disorders of pelvic organs-

  • Endometriosis-most common gynaecological cause of CPP
  • Pelvic inflammatory disease – infection of ovaries, fallopian tubes or uterus
  • Adhesions in abdominal or pelvic region
  • Ovarian cysts
  • Retained ovary syndrome

Urinary tract disorders

  • Abnormal benign growth in bladder
  • Inflammation of bladder lining
  • Inflammation of urinary tract

Disorders of gastrointestinal tract

  • Chronic constipation
  • Inflammatory bowel disease
  • Irritable bowel syndrome
  • Intolerance to gluten

Disorders of musculoskeletal system

  • Weakened pelvic or lower abdominal muscles
  • Poor posture
  • Chronic muscle pain with no obvious cause

In addition to above, there may be several other known causes of the CPP relating to nerve, trauma or back problems

Diagnosis of Pelvic Pain

CPP can be diagnosed with the help of

  • Physical pelvic examination
  • Abdominal or vaginal ultrasound
  • Blood or urine tests
  • Tests for sexually transmitted diseases
  • x-ray, CT scan or MRI

Surgical procedures to diagnose CPP include laparoscopy or hysteroscopy

Sometimes referral to an urologist or gastroenterologist may be required to perform of the checking bladder or bowel.

Treatment for Pelvic Pain

Medications

Common medical treatment includes

  • Pain relievers, antibiotics, muscle relaxants
  • Antidepressants
  • Oral contraceptives

Holistic treatments

Lifestyle changes like reduction in smoking or caffeine intake, dietary improvements may help to reduce symptoms

Physiotherapy to strengthen the pelvic floor muscles or relax trigger points may help in some cases

Complementary therapies like massage or acupuncture are also tried by some patients, however there is no supporting evidence and have increased risk of complications.

Surgical treatments

Laparoscopy may be used to treat gynaecological problems like endometriosis, pelvic adhesions or ovarian cysts

Hysterectomy can be useful in certain cases, however rarely used to treat CPP in isolation

All surgical treatments have their own risks. Please refer to the risk associated with laparoscopy and hysterectomy.