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Chronic Pelvic Pain

Chronic pelvic pain (CPP) is defined as ongoing pain in a woman’s pelvic area (the area between the hips and below the belly button) that lasts for 6 or more months.

According to the National Institutes of Health, about 15 percent of women of childbearing age in the United States report having pelvic pain that lasts at least 6 months. Among them, about 15 percent of employed women have pain that is severe enough to cause them to miss work.

The symptoms of these conditions are variable and often misdiagnosed, causing patients to become frustrated. You should seek out a specialist who has experience treating these symptoms to do a complete history and advanced diagnostic tests. Often, surgical management can lead to long-term or permanent resolution of these symptoms.

The NICHD lists the following health problems as possible causes of Chronic Pelvic Pain:

  • Adhesions. Adhesions are bands of tissue that form between internal tissues and organs and keep them from shifting easily as the body moves.3 They can form as a result of surgery or infections, such as pelvic inflammatory disease.
  • Endometriosis. This condition (pronounced en-doh-mee-tree-OH-sis) occurs when tissues that normally grow inside the uterus grow somewhere else in the pelvis, such as on the outside of the uterus, ovaries, or fallopian tubes. The two most common symptoms of endometriosis are pain and infertility.
  • Interstitial cystitis/painful bladder syndrome. This syndrome (pronounced IN-tur-STISH-uhl siss-TY-tiss) causes bladder pain and a need to urinate often and right away. This pain may be a burning or sharp pain in the bladder or at the opening where urine leaves the body.
  • Irritable bowel syndrome. This syndrome is a digestive problem that can cause pain, bloating, constipation, or diarrhea. Researchers have yet to find a specific cause for irritable bowel syndrome but stress or certain foods can trigger symptoms in some people. (Women who suffer from periodic bowel symptoms that coincide with their period may likely have endometriosis.)
  • Pelvic floor disorders. These disorders occur when the muscles and connective tissues that hold all the pelvic organs in place weaken or are injured. Sometimes the condition is caused by spasms or an increase in pelvic floor muscles tone. Pelvic floor disorders can cause discomfort and pain as well as functional problems, such as trouble with bladder control.
  • Uterine fibroids. Uterine fibroids (pronounced YOO-ter-in FAHY-broidz) are noncancerous tumors made of muscle cells and other tissues that grow within and around the wall of the uterus. Symptoms can include heavy or painful periods, pain during sex, and lower back pain.
  • Vulvodynia. This condition (pronounced vuhl-voh-DIN-ee-uh) involves pain or discomfort of the vulva (the parts of the female sex organs that are on the outside of the body). This condition can cause burning, stinging, itching, or rawness of the vulva.

Dr. Farnam is a specialist in the treatment of these specific conditions. Although the Texas Urogynecology and Laser Surgery Center does not manage chronic fibromyalgia and other myofascial or rheumatological conditions, there are specialists in rheumatology and chronic pain and more information can be found at this National Institutes of Health site.