Chronic Pelvic Pain

Pelvic pain literally means pain in the pelvic (lower tummy) region. By definition, it should have lasted for more than 6 months for it to be labeled as chronic pelvic pain. It is a symptom, not a disease per se. The underlying cause of pain could be a genitor-urinary (genital or urinary), musculoskeletal (muscles & bony), neuropathic (related to nerves), intestinal or even psychological. The doctor tries to find out the cause of the pain, and treat the cause rather than just treating the pain. However, in some cases, it is hard to find a cause, and focus is shifted to just pain relief.

The pain may be dull aching or shar,p mild or severe, constant or intermittent, and may be associated with urination, defecation, different postures and positions, and coitus.

What causes CPP ?

Gynecological
- Endometriosis- A condition where the lining of the womb may also grow outside the womb. It causes painful periods, infertility, painful coitus, sometimes painful urination and defecation.
- Pelvic infection- Referred to as PID’s (pelvic inflammatory diseases), these are chronic infections contracted through sexual contact , ascend from vagina and cervix to involve womb, fallopian tubes and ovaries, and cause pelvic pain.
- Pelvic Congestion Syndrome- Believed to be caused by dilation of veins in pelvic area. This entity has never been proved beyond doubt by research.
- Fibroids – Benign growths in the womb can cause pain / heaviness in the lower tummy.
Gastrointestinal
- Irritable Bowel Syndrome- Associated with constipation or diarrhea and bloating.
Urological
- Interstitial Cystitis- This is also referred to as painful bladder syndrome. Typically, pain starts when bladder fills and gets temporally relieved on irritation. It is associated with urgency, frequency and nocturia.
Musculoskeletal
- Pain arising from muscles and bones of pelvis. This kind of pain is aggravated and relieved in certain postures and positions.
Neurogenic
- It is a sharp shooting type of pain, usually associated with entrapment of nerves.
Psychological
- Usually seen in patients with history of abuse (physical, sexual), chronic anxiety and depression.

When to see a doctor ?

If you experience pain in pelvic area, please see your gynecologist. She will take a detailed history, examine you, order some tests, sonography etc. Based on the results of tests she will treat you. If she finds it necessary, she may advise a Laparoscopy to have a look inside your abdomen through a telescope inserted through a belly button incision.

Treatment

It will depend on the cause of pain. If the doctor finds an infection, she may give you a course of antibiotics. For pain relief, you may be advised to take pain killers. Sometimes, antidepressants may be helpful in relieving pain as well as depression. If the doctor diagnoses you as having endometriosis, you may be advised a laparoscopic surgery.

Unfortunately, in some patients, we are not able to conclude the cause of the pain despite all consultations, referrals, tests, etc. Such patients may require counseling.

Gynaecworld is a center for women's health and well being. With the experience of eminent gynaecologist & fertility specialist, Dr Duru Shah, we make the journey through various stages of your life healthy, focussing on preventive health care.

Every health issue is attended to, and management individualised, suiting your lifestyle and needs!

Be it menarche and its issues, pregnancy- low and high risk, infertility, gynaecological problems like PCOS, fibroids, endometriosis, chronic pelvic pain, laparoscopic & open surgeries, menopausal concerns, nutritional counselling, we are dedicated to providing you the highest quality of health care.

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