Chronic Pelvic Pain

Chronic Pelvic Pain


Chronic pelvic pain is defined as pain in the pelvic region that lasts for 6 months or longer. It usually manifests as pain in the area below the belly button and between the hips which can be constant or intermittent.

It affects approximately 1 in 6 women (15-20%), and can also affect men, though less commonly.

It may be dull, sharp, cramping, or a feeling of pressure/heaviness. It can vary in intensity from mild to severe. It may worsen with certain activities like sitting, sexual intercourse, urination, or bowel movements. It can cause bladder or prostate problems such as pain, discomfort, frequent urination etc.

What causes chronic pelvic pain?

Interstitial cystitis/bladder pain syndrome (IC/BPS)

Description: A chronic condition characterized by bladder pain and discomfort, often accompanied by urinary frequency and urgency.

Symptoms: Suprapubic pain, pain during bladder filling, relief after voiding, frequent urination, and urgency.

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)

Description: A condition involving chronic pain and inflammation of the prostate, often without a clear bacterial infection.

Symptoms: Perineal and genital pain, pain during urination or ejaculation, blood in urine or semen, weak urinary stream, and erectile dysfunction.

Painful bladder syndrome

Description: Similar to IC/BPS, characterized by chronic bladder pain and urinary symptoms.

Symptoms: Pressure, tenderness, pain that lessens after bladder emptying, and reduced bladder capacity.

Pelvic floor dysfunction

Description: Dysfunction of the muscles and connective tissues in the pelvic floor, leading to pain and urinary symptoms.

Symptoms: Pelvic pain, difficulty starting urination, urinary frequency and urgency, and pain during sexual activity.

Urinary tract infections (UTIs)

Description: Infections in any part of the urinary system, including kidneys, bladder, or urethra.

Symptoms: Pain or burning during urination, frequent urination, cloudy or strong-smelling urine, and pelvic pain.

Kidney stones

Description: Hard deposits made of minerals and salts that form inside the kidneys.

Symptoms: Severe pain in the side and back, pain that radiates to the lower abdomen and groin, and painful urination.

Risk factors and associated conditions

Previous Infections: History of UTIs or sexually transmitted infections can increase the risk of developing chronic pelvic pain.

Pelvic Floor Muscle Hypertonia: Overactive pelvic floor muscles can contribute to pain and urinary symptoms.

Neurological Factors: Nerve damage or neurogenic inflammation can play a role in chronic pelvic pain.

Psychological Factors: Stress, anxiety, and depression are often associated with chronic pelvic pain, potentially exacerbating symptoms.

How is chronic pain diagnosed?

Diagnosing chronic pelvic pain involves a thorough medical history, physical examination, and various diagnostic tests to rule out other conditions. Management often requires a multidisciplinary approach, including:

What treatment options are available for chromic pelvic pain?

  • Medications: Pain relievers, anti-inflammatories, muscle relaxants, and sometimes antibiotics.
  • Physical Therapy: Pelvic floor exercises and physical therapy to address muscle dysfunction.
  • Behavioral Therapy: Cognitive-behavioral therapy to manage stress and psychological factors.
  • Lifestyle Modifications: Dietary changes, fluid management, and stress reduction techniques.
  • Understanding the specific urological causes of chronic pelvic pain is crucial for effective diagnosis and tailored treatment, improving patient outcomes and quality of life.

Can chronic pelvic pain be cured?

  • While chronic pelvic pain is often a long-term condition, many patients experience significant improvements in their quality of life through comprehensive management plans. Complete resolution of pain is rare, but flare-ups can be effectively managed.

How does chronic pelvic pain affect daily life?

  • Chronic pelvic pain can severely impact daily activities, work, and personal relationships. It often leads to emotional distress and may require adjustments in lifestyle and ongoing medical support.

What lifestyle changes can help manage chronic pelvic pain?

  • Lifestyle modifications such as dietary changes, regular physical activity, stress management techniques, and maintaining a pain diary can help manage symptoms. Patients are often encouraged to adopt a holistic approach to their health.

What should I expect during a medical consultation for chronic pelvic pain?

  • During a consultation, doctors will ask detailed questions about your pain, medical history, and any previous treatments. They may perform a physical exam and recommend tests to identify possible causes. Open communication with your healthcare provider is crucial for effective management.