Chronic Pelvic Pain In Women –Treatments Options To Calm Down the Symptoms

Chronic Pelvic Pain In Women –Treatments Options To Calm Down the Symptoms

Pain is something that cannot be described easily. The situation can be quite tricky when it comes to explaining pelvic pain, because you never know from where exactly the pain is arising. So it wouldn’t be surprising that a survey by Endometriosis Association states a woman experiencing symptoms of pelvic pain can take as long as 10 years to get correct diagnosis of the condition. Gosh! That’s a long time to live with the pain.

Chronic Pelvic Pain

Chronic pelvic pain in women is referred to pain occurring in the area below the bellybutton and between the hips. This pain is only termed as chronic if it lasts six months or more. Chronic pelvic pain is a condition which can have many causes or it can be a symptom of another disease.

If the chronic pelvic pain is arising from another medical condition, treating that medical problem is enough to eradicate the pain. However, it happens that in many cases it’s nearly impossible to identify a single factor responsible for pelvic pain. We will try to elaborate the causes to help identify or relate your condition with.

Is chronic pelvic pain same in all women?

The type of pain can vary from woman to woman. In some, it can be a mild ache that keeps on recurring, while in some others, the pain can be so solid and severe that it can hinder daily activities and make it hard to sleep properly.

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Causes of Chronic Pelvic Pain

Chronic pelvic pain is quite a baffling condition that can have multiple causes. At times, a single disorder might be identified as the cause, while in other cases, pain could be related to several underlying conditions. For instance, a woman might be suffering from endometriosis and pelvic inflammatory disease, both of which can increase the chances of chronic pelvic pain.
So without further ado, let’s break down the reasons behind chronic pelvic pain in women.

  1. Endometriosis - In this condition, the tissue from the lining of the uterus starts growing outside the uterus. Since its occurring outside the uterus (womb), the blood cannot exit from the body (via vagina) and remain inside the abdomen. It is estimated that 71-87 percent cases of chronic pelvic pain are due to endometriosis.
  2. Chronic pelvic inflammatory disease - The condition occurs due to prolonged infection, often sexually transmitted. This can cause scarring of the pelvic nerves.
  3. Musculoskeletal problems – Conditions that affects bones and tissues such as fibromyalgia, inflammation of the pubic joint and pelvic floor muscle tension result in recurring pelvic pain.
  4. Ovarian remnant - Remains of the ovarian tissues after surgical procedures can develop into painful ovarian cysts, which cause pain in pelvis.
  5. Fibroids – Though these uterine growths are benign, they can still put pressure in the pelvic region.
  6. Irritable bowel syndrome – Symptoms that are related to irritable bowel syndrome such as bloating and constipation can cause pelvic pain.
  7. Pelvic congestion syndrome – Some experts have the opinion that enlarged veins around the uterus and the ovaries can cause pain in the pelvic region.
  8. Painful bladder syndrome – This condition involves recurring pain in the bladder that causes frequent urination. You may feel pain when the bladder fills and relief when after emptying.
  9. Psychological factorsDepression, chronic stress, emotional distress or history of sexual abuse can cause chronic pelvic pain.

Symptoms of chronic pelvic pain

There is not one exact spot where you can point out the pain. If you are asked to locate the pain, you would be sweeping your hands on the entire pelvic area. You would describe the pain in the following ways:

Intermittent pain
Pain that is steady and severe
Sharp pain or cramps
Feeling of heaviness in the pelvic area
Pain during sex
Pain while urinating or bowel movements
Pain that occurs due to prolonged sitting

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Diagnosis of pelvic pain

Be rest assure that you are going to have a detailed interview with the doctor. Besides physically examining you, he will ask about your personal health history and family history of pelvic pain. He will be asking you to list the signs and symptoms. You might be recommended to undergo following tests:

  1. Ultrasound
  2. Laparoscopy
  3. X-Ray
  4. CT Scan
  5. MRI

The diagnosis could be a long process and during the course of time, there is no certainty that the doctor will be able to find out the root cause of pelvic pain.

Treatment of Chronic Pelvic Pain

The aim of the treatment is to reduce the symptoms and improve the quality of life. Following can be recommended.

  1. Medication - Depending on your condition, you might be advised to get pain relievers such as aspirin and ibuprofen. Antibiotics are also an option if the source of pain is infection. In some women, birth control pills or hormonal medication might work well, while antidepressants such as Tricyclic and amitriptyline might be recommended to some others.
  2. Physical therapy – Relaxation techniques, massage and stretching exercises can greatly improve your condition. Many physical therapists use a device called transcutaneous electrical nerve stimulation (TENS). It sends electrical impulses to nerve pathways to ease pain. Some other therapists use a psychotherapy known as biofeedback which helps detect areas of tight muscles so that you can know how to relax those muscles.
  3. Trigger point injections – If your doctor is able to identify the spots where pain is occurring, he might give you a numbing injection to ease pain in those specific points. Trigger points is a local anesthesia that lasts long.
  4. Neurostimulation (spinal cord stimulation) – This treatment requires implanting a surgical device about the size of a stopwatch. It blocks nerve pathways that stop the pain signals reaching the brain.
  5. Surgery – If the cause of pain is some underlying condition such as endometriosis, the doctor may suggest laparoscopic surgery to remove the faulty tissue. In other rare cases, doctor may opt for removing ovaries (oophorectomy), fallopian tubes (salpingectomy) and even removing the uterus (hysterectomy).

Chronic pelvic pain can have a long lasting impact on your day to day life. So talk to the gynecologist as soon as you start experiencing any of the symptoms. The early the diagnosis is made, the better you can work on treatment and improve the quality of life.

Sources

1. Pelvic inflammatory disease (2015). ACOG read more
2. Pelvic inflammatory disease (PID) (2015). CDC read more
3. Pelvic inflammatory disease [fact sheet] (2017). womenshealth read more
4. About Pelvic Pain (2017). NIH 
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