What is Pelvic Pain or Chronic Pelvic Pain?
Pelvic Pain is distressing and affects your quality of everyday life. If you are suffering its right to talk to someone and not suffer in silence. Some women find it embarrassing to talk about it and we understand this. Every woman we talk to says they have felt better after talking to someone about the problem. What you might not know is it’s a common condition that affects around 1 in 6 women.
Pelvic Pain is pain in the lower abdomen or pelvis. It can be that the pain occurs all of the time or some of the time. If the pain has been there for more than 6 months, it is then known as chronic pelvic pain.
What causes Chronic Pelvic pain?
Pelvic Pain often comes from a number of things that may be, physical, psychological and/or social factors. Sometimes it’s hard to work out the cause and it may be a combination of things.
Some possible causes are;
- Endometriosis– this is a condition where the cells lining of the womb appear elsewhere in the body, typically in the pelvis causing discomfort.
- Pelvic inflammatory disease – this is an infection which occurs in the fallopian tubes and/or in the pelvis.
- Trapped or damaged nerves in the pelvic area e.g. from an accident or childbirth.
- Adhesions or scaring – there are areas of scar tissue which may be a result of a previous infection, endometriosis or surgery.
- Pelvic organ prolapse
- Musculoskeletal pain (pain in joints, muscles, ligaments and bones of pelvis)
- Irritable bowel syndrome (IBS)
- Depression, including postnatal depression
Diagnosing pelvic pain
Understanding more about you and the pain helps us to understand things better and it will help determine the right tests and treatments for you.
In some cases, we will need to examine things in more detail to discover more about the underlying causes.
Some of the tests you may receive are;
- Screening tests for pelvic infections
- An ultrasound scan- this may happen as a transvaginal scan of your pelvis
- An MRI scan of your pelvis
Treatments and tests
The type of treatment and tests you may receive to help with Pelvic Pain all depend on;
- The pattern of your pain
- What makes your pain better or worse? (E.g. if you sit or stand is it worse, if you use heat or cold does it improve)
- Any medications you use
- Any other linked problems with your periods, when you have sex, if you have bladder or bowel problems or if you have had or have psychological issues
For some women we offer a laparoscopy, this is when there is a chance you have endometriosis, adhesions or pelvic infections.
In some cases, Pelvic Pain occurs because of one specific problem. If this is the case, then you will have treatments for that specific condition for example;
- IBS- medication and diet change may help
- Infections- usually treated with antibiotics
- If the pain correlates with your periods you may receive hormone treatments such as the pill, injections or the hormone coil
- Surgery for mild adhesions does not appear to help pelvic pain, however surgery may occur in cases of severe adhesions, left from endometriosis or past surgeries.
Sometimes there is no obvious cause and the pain in this case needs to be managed. Of all the laparoscopies carried out 30% – 50% find no obvious cause of the pain. This doesn’t mean the pain isn’t there it means nothing can be diagnosed with the tests we have available. It helps to be taken seriously and it helps to talk about it. It’s often reassuring to know there are no serious issues causing the pain.
In other cases, there are a combination of things causing the pain and the treatment is a programme to discover what is the best option.