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BellaOnline's Gynecology Editor

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Chronic Pelvic Pain

Guest Author - Linda Reid

Pelvic pain is any pain felt below the bellybutton and between the hip bones. It is classified as chronic if it has persisted for a duration of three to six months or longer. It can be sporadic or continuous. Studies estimate that as many as 10% of women seeing a gynaecologist are seeking help for chronic pelvic pain (CPP).

There are so many reasons for CPP, they are almost too numerous to list and even though this siteís focus is on gynecology, it is important to note that pain that might be associated with the reproductive system could be coming from another source. As well, although the pain may not have its genesis in the reproductive system some functions such as menstruation, sexual intercourse and hormonal imbalances may aggravate the condition and cause you to think it is a reproductive system disorder.

The following is a list of common disorders that may cause CPP. Remember, there is a difference between acute and chronic pain. If you are just now experiencing sudden, extreme pain that may or may not be accompanied by one or more of the following: unusual bleeding, nausea, vomiting or fever, stop reading now and go to your nearest hospital emergency department or health care provider, immediately.

Ovarian Cysts: Most ovarian cysts are innocuous and come and go without ever being detected. While they may cause some minimal discomfort, it is often not enough to seek medical attention. There are many different kinds of cysts and the causes vary. Sometimes, however, they can cause pain and may require removal.

Dysmenorrhea: Painful menstrual periods are not unusual, but it is considered abnormal if the pain interferes with normal daily activities. Usually caused by compounds called prostaglandins in menstrual blood, common medications such as Aspirin and Motrin can relieve the pain by inhibiting the production of prostaglandins. Birth control pills are also used to decrease cramping.

Endometriosis: This is a condition in which tissue that lines the uterus and is normally shed during menstruation, grows outside the uterus. This condition can be very painful and is difficult to treat. In some cases a hysterectomy is required but endometrial tissue may still be left behind as it can adhere to any organs in the pelvic region.

Cancer: Cancers of the pelvic organs can cause pain but often not until the cancer has reached a life-threatening stage. This is why regular checkups with your healthcare provider are important and necessary.

Fibroids: These are benign growths that develop with or attach to the wall of the uterus. They can cause excessive menstrual bleeding, pain, and frequent urination and are the primary cause of hysterectomy.

Pelvic Inflammatory Disease (PID): PID is an infection that occurs in the uterus, fallopian tubes and ovaries. The cervix (the opening to the uterus) is normally an effective barrier against infection, but if it is exposed to a sexually transmitted disease such as Chlamydia and becomes infected, it allows bacteria to migrate to the internal organs causing inflammation and infection.

Pelvic Adhesions: This is a condition in which two or more organs are fused together with scar tissue and can occur as a result of previous surgery, pelvic infection (PID) and endometriosis.

Pelvic Prolapse: Usually causing pain during intercourse, this condition is a result of a weakening of the sling of muscles at the base of the pelvis that hold the pelvic organs in place. When this support begins to break down, it causes the pelvic organs to shift and press against the vagina.

Pain from Other Organs

Bladder: Inflammation of the bladder will cause pain in the lower part of the abdomen. This may be caused by a bladder infection or a condition called interstitial cystitis.

Colon: The colon is situated next to the uterus and ovary. Constipation and intestinal inflammation may cause pain. If you have Irritable Bowel Syndrome or Crohnís Disease you will have pain and discomfort in the pelvic region.

Diagnosing CPP

In order to determine the cause of your CPP, your healthcare provider will ask you questions about the pain i.e. where do you feel the pain, is it cyclic (does it occur intermittently for instance only during your period, between periods) or is it constant? What are you doing when you experience the pain? You will most likely have a pelvic examination at which time your doctor will look for tenderness or abnormalities and possibly do a Pap test and take a culture to look for disease or infection. You may need to undergo procedures such as a laparoscopy, ultrasound or x-ray.

Even after testing, it is sometimes impossible to determine the cause of the pain. This does not mean there is no cause, only that medical science, at this time, is unable to find it.

If you are experiencing chronic pelvic pain, see your doctor. You need the expertise of a physician to rule out all known possibilities for your pain. Your physician will also be able to help you manage your pain, because if it canít be cured, it can be relieved. Above all, donít give in and donít give up. Chronic pain can be incapacitating, emotionally and physically. If you are becoming depressed and suffering from feelings of helplessness and hopelessness, tell your doctor. Depression can be treated and emotional pain is just as valid as physical pain.

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Content copyright © 2014 by Linda Reid. All rights reserved.
This content was written by Linda Reid. If you wish to use this content in any manner, you need written permission. Contact Dr. Denise Howard for details.

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