Pelvic pain is a pain located in the lower part of the abdomen, called the pelvis or pelvic cavity. It is common in women and can affect any of the organs present in the pelvis, such as the internal genital organs, the bladder and the intestine.
What is Chronic Pelvic Pain?
Chronic pelvic pain is pain in the area below the belly button and between the hips that lasts six months or longer and may have more than one cause. It may be a symptom of another disease or a condition in itself.
If your pelvic pain seems to be caused by another health problem, treating that problem may get rid of the pain, although many times, tests can't find a cause for the pelvic pain. In that case, the goal of treatment is to relieve the pain and other symptoms, which can improve your quality of life.
Causes of chronic pelvic pain
There are many causes that can lead to chronic pelvic pain, including emotional factors such as chronic stress or depression. In addition, a history of sexual or physical abuse increases the risk of suffering from it. In many cases, it is related to other diseases and can even be an illness in itself. In the first case, that is, when it derives from another pathology, it can disappear with treatment for it, but unfortunately it is not always so easy to identify the causes; therefore, the objective of the treatment is to improve the quality of life and reduce the sensation of pain.
The causes can sometimes be easy to identify when they arise from a specific condition. But it is also possible that it is the consequence of several simultaneous pathologies, in which several systems and apparatus are involved without being able to attribute it to a single cause, which is why these cases of pelvic pain are considered multifactorial.
Some of the causes identified:
Causes of gynecological origin:
Endometriosis
Adenomyosis
Pelvic inflammatory disease
Ovarian cysts; residual ovarian syndrome,
Pelvic congestion,
Urological origin:
Interstitial cystitis
Chronic prostatitis
Gastrointestinal origin:
Irritable bowel syndrome
Musculoskeletal origin:
These can be diverse, such as joint inflammation, increased pelvic floor tone, pelvic floor myofascial syndrome, sacroiliac joint dysfunction, fibromyalgia, hernias that can lead to recurrent pelvic pain…
Symptoms of chronic pelvic pain
Given the multicausality of this condition and the pelvic neurophysiological complexity, the coexistence of several types of pain is frequent: neuropathic, visceral, myofascial, referred pain and pain with central sensitization symptoms.
The primary symptom, pain, can present itself in many different ways: intense and constant, intermittent, in the form of sharp pains or in the form of pressure in a deep area of the pelvis, abdomen or lower back, etc.
It may appear associated with symptoms suggestive of lower urinary tract pathology, sexual disorders, intestinal or gynecological pathology; such as pain during sexual intercourse, pain with bowel movements, pain when urinating or defecating, pain with certain movements or simply increased pain during sitting. The pain itself can vary greatly in terms of characteristics and intensity and should be carefully studied.
It is essential that, from the onset of these symptoms, you consult with a pelvic floor specialist (gynecology, urology, pelvic floor rehabilitation physician, gastroenterology), to study the possible causes and apply the appropriate treatment.
How is pelvic pain treated?
Treatment depends on the cause of the pelvic pain, its intensity, and its frequency. No single treatment approach has been shown to be better than another in all cases.
Some treatment options:
Medications. Many types of medications are used to treat pelvic pain, including oral and injectable pain relievers, muscle relaxants, and antidepressants.
Hormonal treatment . Hormones may help relieve pain associated with endometriosis and menstruation. Hormones may be given orally, such as birth control pills, by injection, such as gonadotropin-releasing hormone (GnRH) injections, or placed in the uterus, such as progestin-releasing intrauterine devices. Hormonal treatment for pelvic pain is not the same hormone therapy that is sometimes used to treat menopausal symptoms.
Lifestyle changes . Some women's pain is relieved by making dietary changes, improving posture, and engaging in regular physical activity.
Physical therapy . Some types of pain, such as pain in muscles and connective tissues, respond well to physical therapy. This type of therapy might include massage, stretching, strength exercises, or learning to relax or control your pelvic muscles.
Surgery . Some women may need surgery to remove adhesions, fibroids, and/or endometriosis. In some cases, surgery may also reduce or relieve pelvic pain. Some women may have surgery to cut or destroy nerves to stop pain signals, but these surgeries are not usually successful.
Depending on the cause of the pain, a woman's doctor may recommend a hysterectomy, a surgery to remove a woman's uterus, to relieve or reduce pelvic pain.
Psychological therapy . Psychological therapy can help treat pain; in fact, the combined use of therapy and medical treatment often improves symptoms more than medical treatment alone.
Finding a treatment that works can take time, and some women try alternative therapies to relieve pain. Learning to cope with pain in a healthy way is an important aspect of any treatment approach.
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