Pelvic pain is not something most women want to discuss, but it’s more common than many realize. Most women will experience at least some form of pelvic discomfort in her lifetime, and chronic pelvic pain — pain that lasts for six months or longer — affects up to 33% of women, according to research from Brigham and Women’s Hospital.
Despite its prevalence, relatively little is understood about the condition. Women who experience chronic pelvic pain may visit a number of physicians and specialists in hopes of understanding the cause of the disease and what they can do to relieve their symptoms.
An Abundance of Causes
One of the most difficult things about understanding and treating pelvic pain is narrowing down what exactly could be the cause of it.
For about 20 percent of the instances of pelvic pain, the causes are often gynecologic. Those could include:
- Endometriosis, in which the tissue that lines the uterus also grows outside the uterus, which can cause discomfort and even fertility problems
- Pelvic adhesive disease, which causes adhesions — abnormal tissue that can form due to infection, inflammation or after surgery — that causes organs, such as ovaries and fallopian tubes, to stick to surrounding tissues and organs
- Pelvic inflammatory disease, which is an infection that is usually acquired through sexual transmission — though it can also be caused by problems like diverticulitis, tuberculosis or a ruptured appendix — that can involve the fallopian tubes, ovaries or uterus
Non-gynecological causes can also be the source of chronic pelvic pain, such as irritable bowel syndrome (IBS) or fibromyalgia.
The pain can also be a product of a condition called painful bladder syndrome, or PBS, as well as interstitial cystitis (IC). Collectively, PBS/IC refers to bladder pain that’s not caused from a bladder infection. PBS/IC can cause you to need to urinate frequently or urgently, and many women with PBS/IC also present with pain in their pelvis or lower abdomen.
Another possible cause is pelvic floor dysfunction, which can cause pain in the pelvis, as well as pain with urination. Pelvic floor pain can also make it difficult to urinate, cause constipation and pain with intercourse.
A Variety of Treatments
Treatment depends on the cause of pelvic pain — which itself cannot always be easily determined.
One tactic for managing chronic pelvic pain is prescribing a sequence of medications known to alleviate the various causes of pelvic pain until a treatment is found to work. For instance, a medical provider may, for a short time, prescribe a medication known to alleviate pain from endometriosis. If this is effective, good; if not, then another medication will be prescribed for a short time. Intensive diagnostic testing can help steer the prescription of medications for treatment by narrowing down the possible causes of the pain.
In some instances, pelvic floor physical therapy can help relieve symptoms. This therapy is aimed at helping to loosen and relax the muscles of the pelvic floor by focusing on the abdomen, hips, lower back, thighs and vagina.
Surgical solutions are also available. These can include the surgical removal of endometrial tissue outside the uterus, severing nerves that are transmitting pain signals to the brain or even hysterectomy.
If you’re suffering from pelvic pain, discuss your symptoms with your gynecologist or a urology medicine specialist. Treatment can have a marked improvement in your quality of life.
For more information about urology services at Tanner, visit Tanner Urology Care.