Pelvic pain in women is a unique condition in that it can either be an ailment all its own or a symptom of another disease. Chronic pelvic pain is pain that can be felt in the lowest part of the abdomen and pelvis. Often, it doesn’t involve a specific pinpointed area but rather a large sweeping sensation that can be felt throughout the region.
Although not every case of the condition is chronic, pelvic pain becomes chronic when it lasts for six months or longer. Although there is no specific cause for the condition, treatment can be provided if the source of the pain can be deducted from the symptoms that a patient is exhibiting. However, if no cause is found, treatment will focus on managing the pain of this condition, bettering the quality of life for those who have developed it.
Common Culprits of Chronic Pelvic Pain
Although there are no definitive causes of chronic pelvic pain, there are many conditions that are thought to be possible sources of the ailment.
One common cause of chronic pelvic pain is Endometriosis, a condition in which the tissue from the lining of the uterus begins to grow outside of the uterus itself. This tissue is responsive to menstruation, meaning that each month it sheds, just like tissue in the uterus does. This remains in the body, however, leading to possible, and quite painful, cysts and scar tissue, or adhesions.
Chronic Pelvic Inflammatory Disease is another possible culprit for chronic pelvic pain. Most often, this condition occurs from long-term infections, which can cause scarring that involves the pelvic organs.
Aside from the reproductive organs themselves, other body structures can also be involved in the onset of chronic pelvic pain. The large intestine is one such example, as its role in Irritable Bowel Syndrome, which results in bloating, constipation and diarrhea, can often lead to uncomfortable pain and pressure in the pelvis. Also, Painful Bladder Syndrome, or Interstitial Cystitis, results from chronic inflammation of the bladder, which can cause pelvic pain as the bladder becomes more full.
Cognitive factors can also cause more complications when it comes to the pelvis and chronic pain. Depression, stress or abuse can all increase the chances of a woman developing chronic pelvic pain. Because emotional stress exacerbates a woman’s symptoms, it is imperative that chronic pain be managed so as to not feed a vicious cycle of debilitating pelvic pain.
The most important thing to remember is that chronic pelvic pain can result from any number of conditions or body structures. Anything located in the lower region of the body is fair game for causing chronic pelvic pain, making diagnosis and treatment particularly challenging.
Signs and Symptoms of Chronic Pelvic Pain
The signs and symptoms of chronic pelvic pain can be varied in both the types of symptoms being experienced and the intensity with which they are experienced.
The most common symptoms of chronic pelvic pain include severe and steady pain, which can sometimes be intermittent, a dull, aching feeling, sharp pains or cramping and a pressure deep within the pelvis.
Other signs of chronic pelvic pain include pain during sexual intercourse, pain while having a bowel movement, pain while urinating and pain when sitting for long periods of time. Often times, the pain associated with sitting can be relieved by lying down, although this is not true for everyone.
Chronic pelvic pain, like all chronic pain conditions, can often lead to depression as well. This necessitates the need of a counselor or therapist for a person, as cognition has a lot to do with physical symptoms and well-being.
Diagnosing the Etiology of Chronic Pelvic Pain
Much like other chronic pain disorders, pelvic pain requires a process of elimination to determine what is truly at the root of the problem. Doctors can execute a variety of tests to attempt to deduce an answer to the pain in addition to interviewing a patient about their family history and personal health history.
A doctor will often begin with a physical pelvic exam after the interview to check for any signs of infection, which can be later determined by taking cultures, any abnormal growths or any signs of tense pelvic floor muscles. A physician might also press gently on certain areas to determine exactly what parts of the pelvis hurt more than others as this can help determine what may be the cause of the discomfort.
Ultrasounds and other imaging tests are another common option used by doctors to further examine a patient’s discomfort. Some imaging tests for chronic pelvic pain include x-rays, CT scans or MRIs, all of which can help to depict any abnormal structures that might be growing in, and around, the pelvis.
The most intrusive test that can be performed to aid in the diagnosis process is laparoscopy, during which a doctor inserts a thin tube with a camera through a small incision in the abdomen. This test checks more thoroughly for growths and abnormal tissue, which may be harder to detect on other imaging scans. In particular, this procedure is often used to help detect Endometriosis and Chronic Pelvic Inflammatory Disease.
Although diagnosis can be a long, and sometimes intrusive, process, it is a necessary step on the road to recovery from chronic pelvic pain.
On the Right Track for Treatment
For some women, doctors are able to pinpoint the cause of discomfort, making treatment much simpler. For others, however, treatment can be a process of guesswork because too many details remain unknown. In any case, physicians are able to prescribe treatments that will help manage the pain and treat any underlying conditions that can be detected.
Medications are a common source of treatment for chronic pelvic pain. Frequently prescribed medications include pain relievers, hormone treatments, antibiotics and antidepressants. Pain medication by itself hardly ever provides relief for all of the symptoms of pelvic pain, however it is effective in offering some relief from the discomfort of the condition.
If a doctor finds that the problem is related to the reproductive system, hormone treatments might be effective to help relieve cyclic pelvic pain. Additionally, antibiotics are used should an infection be involved with chronic pelvic pain. Antidepressants are also found to be effective in relieving the symptoms of many chronic pain disorders, including pelvic pain.
Therapies might also be prescribed in addition to any medicinal treatments. Physical therapy is one option, as stretching exercises, massage and other relaxation techniques are often effective at relieving chronic pelvic pain. The pelvic floor muscles are often a key area to work on during physical therapy, relieving one possible source of pelvic pain.
Trigger point injections are another option for women, especially if there is pain in specific parts of the pelvis. This allows for temporary relief from the pain, which can help to ease discomfort. In addition to physical therapies, counseling is another vital part of the recovery process. Chronic pain is often associated with underlying mental processes. Therefore, by managing cognitive symptoms, physical symptoms will be managed as well.
Surgery is the most extreme form of treatment and is typically only used should there be a major problem underlying the chronic pelvic pain. Laparoscopic surgery is a common procedure used for Endometriosis in which a physician inserts instruments through a small abdominal incision to remove the necessary tissue. Another option is having a complete Hysterectomy procedure done, although this is quite rare. This is usually only done for women past the age of childbearing and can be quite risky. For this reason, a Hysterectomy is performed as a last resort for those patients who truly need it.
Advice for Coping With Chronic Pelvic Pain
One of the biggest frustrations when it comes to chronic pelvic pain is the influence that the discomfort can have on a woman’s daily activities. When symptoms worsen, many women have trouble doing everything from sleeping to exercising. The anxiety and stress provoked by the condition only makes things worse, making stress management an important aspect of coping with chronic pelvic pain.
Managing stress at home is easy should an individual have enough concentration to stay focused on their relaxation. Practicing meditation, employing the use of deep breathing, increasing the amount of physical activity in one day and getting enough sleep are all vital to maintaining mental and physical health. Ice and heat are other good options to use for days when relaxation just isn’t cutting it, helping to soothe symptoms and maintain a state of relaxation.
Doing research on the topic can also be good for someone seeking support. Often, a woman can find either a support group tailored toward their specific condition. This is not only encouraging, but extremely helpful for any woman who feels as if no one understands what she is going through.
Chronic pelvic pain doesn’t have to be a defining feature of anyone’s life. In fact, many women should feel empowered through the ability to defeat the condition and live their normal, happy lives. With treatment options that can be tailored to meet specific needs, women can rest assured that their chronic pelvic pain will not only be handled, but will stay away for as long as possible as well.