Chronic Pelvic Pain
Chronic pelvic pain is pain in the pelvic area that lasts for six months or longer. Chronic pain can come and go, or it can be constant. Sometimes chronic pelvic pain follows a regular cycle. For example, it may occur during menstruation. It also can occur only at certain times, such as before or after eating, while urinating or during sex.
Chronic pelvic pain can be caused by a variety of conditions. Some of these conditions may not be related to the reproductive organs but to the urinary tract or bowel. Some women have more than one condition that might be the cause of their pain. For some women with chronic pelvic pain, no cause is found.
Diagnosis
We will ask about your medical history. You will have a physical exam, including a pelvic exam. Tests also may be done to find the cause. It also may be necessary to see other specialists to find out the cause of your pain, such as a gastroenterologist or urogynecologist. Some of the following imaging tests may be performed:
- Ultrasound
- Laparoscopy
- Cystoscopy
- Colonscopy
- Sigmoidoscopy
Treatments
Several pain-relief measures can be used to treat chronic pelvic pain. They include medications, physical therapy, nutritional therapy and surgery:
- Lifestyle changes: Good posture and regular exercise may help reduce pelvic pain.
- Pain-relieving drugs: Nonsteroidal anti-inflammatory drugs (NSAIDs) are helpful in relieving pelvic pain, especially dysmenorrhea.
- Physical therapy: Acupuncture, acupressure and nerve stimulation therapies may be useful in treating pain caused by dysmenorrhea. Physical therapy that eases trigger points may give relief of muscular pain. Some types of physical therapy teach mental techniques for coping with pain. Such types include relaxation exercises and biofeedback.
- Nutrition therapy: Vitamin B1 and magnesium may be used to relieve dysmenorrhea.
- Surgery: Pelvic pain that does not respond to other treatments can be relieved by surgery. Cutting or destroying nerves blocks pain signals from reaching tissues and organs.