Chronic Pelvic Pain
By Dr. Shehrebanu Merchant
Chronic pelvic pain is defined as pain in the pelvic region (below the bellybutton and between the hips) that lasts for six months or longer. Pelvic pain may be a symptom of another disease, or it may be a condition on its own. Thus, the cause of chronic pelvic pain is often difficult to find, and sometimes the cause may never be found.
Signs and Symptoms:
Pelvic pain may present with one or multiple symptoms, including severe and steady pain, pain that comes and goes, dull aching pain or sharp, cramping pains, and pressure or heaviness deep within the pelvis. At times the pain is most evident during intercourse, while having a bowel movement, or when sitting down.
Causes:
Common causes of chronic pelvic pain include but are not limited to the following: endometriosis, dysmenorrhea (pain during periods), pelvic floor muscle tension, chronic pelvic inflammatory disease, pelvic congestion syndrome, ovarian cysts, uterine fibroids, vaginal infection, irritable bowel syndrome, interstitial cystitis, muscular or skeletal problems, and psychological factors.
Diagnosis:
Specific tests and examinations may help in diagnosing the cause of chronic pelvic pain. The work-up will most likely include a pelvic examination, appropriate vaginal cultures, imaging studies (most likely ultrasound) and potentially laparoscopy, colonoscopy, or cystoscopy.
Treatment:
Management of chronic pelvic pain will be determined by what is causing the pain. Possible treatments may include pain relievers, antibiotics, hormonal treatments, antidepressants, physical therapy, counseling, and surgery. Lifestyle changes such as good posture and regular exercise can also help reduce pelvic pain.
Dr. Merchant is a board-certified obstetrician and gynecologist who has been practicing in the Northwest suburbs of Chicago for the last 27 years.
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