Pelvic Pain Awareness

This month is pelvic pain awareness month. This is a time to share your experiences, support and listen to others in a safe space. In this week's blog we will be discussing chronic pelvic pain, where it comes from, how to manage it and how it affects our bodies.

 

What is chronic pelvic pain


Chronic pelvic pain is one of the most common health care problems. It is estimated that 25 million women suffer from chronic pelvic pain. Approximately 25% of women with chronic pelvic pain may spend 2-3 days in bed each month. More than half of the women with chronic pelvic pain cut down on their daily activities one or more days a month, and 90% of women experience pain with sex. (3)

Pelvic pain can really take a toll on your body with an estimated half of women experiencing sadness and even depression. 

However this is not easy to diagnose.

Your GP will need a very thorough history of your pelvic problems. After an examination, your GP will be able to determine what further tests  will need to be taken in order to find the source of your pain. 

 

Your GP will ask questions like:¹

  • How and when did your pain begin?

  • Which activities make it worse?

  • Does pain affect your sleep?

  • Has the pain spread since it began?

As much detail and accuracy you can give goes a long way.


What Causes Pelvic Pain in Women?

Pelvic pain can be felt in the lower belly. Just like any other illness people experience it differently, it can be sudden and severe, known as acute pelvic pain. or can last for 6 months and or longer, known as chronic pelvic pain.


Some symptoms of pelvic pain:²

  • a sudden sharp, stabbing or burning pain
  • a slow-releasing pain which never goes away
  • light or heavy aching sensation
  • feeling of pressure on the blower belly
  • a twisted or knotted feeling in your belly
  • cramping or throbbing pain which may come and go
  • pain when active (during sex, exercise or peeing)


There are a few common causes such as constipation, UTI’s, STI’s and irritable bowel syndrome. Most of the time pelvic pain is caused by an infection affecting one of the organs surrounding the pelvic area like the bowel or bladder.


In women, pelvic pain is more common. 

  • period pains
  • conditions where the reproductive system are involved (endometriosis, ovarian cyst)
  • pelvic pain during pregnancy


In some cases pelvic pain can be something more serious like an ectopic pregnancy (when the egg is fertilised in the fallopian tube) ovarian or womb cancer.
Please do not self-diagnose, speak to a professional if you have any worries.

 

Can Chronic Pelvic Pain Go Away On Its Own

The short answer is no, chronic pelvic pain is a disease that needs long term management.


Like any other disease, chronic pelvic pain can massively affect your day to day quality of life. If the source of your pain is pinpointed then your treatment will be given accordingly but in other cases the target is pain management.


Unfortunately in some cases when women seek help and described their pain to doctors they can still have trouble with getting a diagnosis which has been understood to lead to anxiety and depression which can in fact make the pain worse.
But, you should never let a doctor make you feel like it's all in your head. Every doctor is different and getting another opinion could be exactly what you need.

How Does Pelvic Pain Affect The Pelvic Floor

how does pelvic floor affect chronic pain


Pelvic pain can be caused by the infection of an organ in the pelvic area. 
Let's use the bowel for an example, the pain in your bowel can cause pain in the pelvic floor. As a result the muscles can start to break down. The loss of muscle and strength is what causes a weak pelvic floor.


Pelvic floor exercises which are known as Kegels were developed by Californian Gynaecologist Dr Arnold Kegel. These are exercises which are clinically proven as an effective nonsurgical treatment for pelvic floor weakness.
By doing your Kegels this helps to strengthen your pelvic floor muscles, which supports the uterus, bladder, small intestine and rectum. 


You can feel your pelvic floor muscles when you try to stop the flow of urine when on the toilet but it is not recommended that you do this regularly as it can cause damage to the bladder.

 

How To Manage Pelvic Pain


Usually, if the main pain source is not found, the main goal of treating pelvic pain is pain management and reducing the symptoms.

what do doctors recommend for chronic pelvic pain

Depending on the cause a doctor will prescribe different medications such as:

  1. Over the counter pain relievers. Many will partially relieve some pain in some cases prescription pain medications may be needed. Sadly in most cases this is just not enough. 

  2. Hormone treatments. If the pain is linked with your menstrual cycle, women find the hormonal changes that control ovulation and menstruation help. This can be a contraceptive pill or other hormone medications.

  3. Antibiotics. If an infection is the source of the pain, antibiotics can be taken to relieve the infection therefore relieving pelvic pain.

  4. Antidepressants. Some antidepressants can in fact help with chronic pain conditions as they have pain relieving as well as pain relieving effects. This could help a woman who does not have depression.

  5. Physical therapy. stretching exercises, relaxation techniques and kegel exercises can help pelvic pain. Sometimes a physio can target a specific area using a pelvic floor device.

  6. Spinal cord stimulation. This involves planting a device which blocks nerve pathways so that the pain signal cannot reach the brain.

  7. Trigger point injections. If the specific cause of your pain is identified, numbing medications can be injected into the area.

  8. Psychotherapy. if your pain is linked with depression, sexual abuse, mental illness or stress, you may find it helpful to talk to a therapist.

Sadly there is no simple easy fix which works for everyone, so that's why this month it is so important to share your experiences and help support women who are struggling. Remember, if you are suffering with pelvic pain and you are not getting the support or advice you deserve, please keep asking to be referred until you are listen to.



Sources used:

https://www.bvhealthsystem.org/expert-health-articles/may-is-pelvic-pain-awareness- month#:~:text=May%20Is%20Pelvic%20Pain%20Awareness%20Month (1)

https://www.nhs.uk/conditions/pelvic-pain/ (2)

https://www.mayoclinic.org/diseases-conditions/chronic-pelvic-pain/symptoms-causes/syc-20354368#:~:text=Chronic%20pelvic%20pain%20is%20pain,condition%20in%20its%20own%20right.  (3)

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