The 411 on chronic pelvic pain

We know — it’s not normally a topic of conversation. But chronic pelvic pain is a common issue in the United States, affecting around 15 percent of all American women. Here’s what you should know.

First things first, what exactly is pelvic pain? Pelvic pain is pain affecting the area below your belly button and in between your hips.

It becomes chronic pain when it lingers for six months or longer.

But what exactly causes this pain, and how can it be remedied? Read on for a deep dive into chronic pelvic pain and what it means for women.

Chronic pelvic pain: Where it hurts

We defined above the area of the body where pelvic pain occurs, but let’s get a little more granular. You may experience pelvic pain as a general ache in the area of your pelvic region.

But you may also experience it in specific spots, including your pelvis, the abdominal wall, your lower back or even the buttocks.

Chronic pelvic pain: How it hurts

Just as the location varies, so does the type of pain a woman may experience. A woman having pelvic pain may feel:

• Steady severe pain
• Pain that comes and goes
• Dull ache
• Sharp cramping
• Pressure in the pelvis

Along with those feelings of pain, women who experience chronic pelvic pain also may feel pain during sexual intercourse, pain while using the restroom, or pain when sitting or standing for a length of time.

There’s no single experience that defines pelvic pain. And a woman who has chronic pelvic pain may experience pain in different ways at different times.

Chronic pelvic pain: When it becomes chronic

By definition, pain becomes chronic when it lasts for six months or longer. But there are other common factors for women who experience chronic pelvic pain.

The International Pelvic Pain Society identifies some other things affected women have in common:

• Little relief from conventional treatments
• Depressed body reactions, such as a lack of sleep, constipation or a decreased appetite
• Limited physical activity
• Emotional issues

If you experience pelvic pain that lingers or that is impacting your daily life, talk with your doctor about what you’re feeling. He or she can work with you to identify the underlying cause and offer suggestions for treating the condition or eliminating pain.

Chronic pelvic pain: Understanding the causes

The first step toward treating pelvic pain is finding the underlying cause of the pain. There are many conditions that can lead to pelvic pain, including:

• Endometriosis, a condition where uterine tissue grows outside the uterus, affects millions of American women. Because the tissue is growing outside the uterus, the tissue and blood can’t exit the body as they would during a normal period. Instead, they remain in the abdomen, leading to scar tissue and pain.
• Chronic pelvic inflammatory disease, which occurs when an infection, which may or may not be sexually transmitted, lingers and causes scarring around the pelvic organs.
• Fibroids, noncancerous growths in the uterus, can cause a feeling of pressure or heaviness in the abdomen. They can also cause severe, sharp pain.
• Irritable bowel syndrome, which affects the large intestine, is a fairly common issue. IBS, as it’s known, impacts as many as 45 million Americans, with the majority of them female. The condition causes a variety of symptoms, including changes in bowel habits, bloating and abdominal pain.
• Interstitial cystitis, a condition that’s also called painful bladder syndrome, causes a recurring pain in the bladder and a frequent need to urinate. Pelvic pain increases as the bladder fills.
• Musculoskeletal issues are another potential cause. Conditions that impact the bones, joints and soft tissues, like fibromyalgia, are tied with recurring pelvic pain.
• Ovarian cancer may cause symptoms in the pelvis including pain, pressure, and discomfort. Because pelvic pain can be a sign of so many other conditions, it is important to note if the pain is persistent and a change from normal which can be a sign of ovarian cancer.

Chronic pelvic pain: Diagnosis & treatment

We mentioned that the first step toward the treatment of chronic pelvic pain is discovering its underlying cause. But how do physicians do that?

A comprehensive approach is required, starting with a physical exam. As part of your medical visit, a doctor may use a pelvic exam, lab tests, imaging tests and even laparoscopy to determine what’s causing pain.

Once the underlying cause is discovered, treatment will vary depending on the cause, but may include oral or injected medications (such as antibiotics and anti-inflammatory medications), physical therapy, psychotherapy, neurostimulation and surgery.

The first step toward finding a solution for your chronic pelvic pain is talking with your doctor. Need a doctor? Book an appointment with Dr. Charles Portera.