Chronic pelvic pain is one of the most common medical problems women face. In contrast to acute pelvic pain that has a cause – an infection in the appendix, for example – chronic pelvic pain, or CPP, has no obvious cause. In many cases, the original source of the pain is gone, but the body has compensated for it in the muscles, nervous system and tissue and they are now causing the pain.
CPP refers to any pain in the pelvic region that lasts six months or longer. It doesn’t have a specific point of pain usually. It can either be a symptom of something else that is going on in your body or it can be a disease itself.
Because the original cause of the pain may have heeled long ago, it can be hard to diagnosis the source of the pain. That doesn’t mean that the pain isn’t real or that it’s all in your head. It is very real and it can be extremely debilitating.
Some of the most common causes of chronic pelvic pain are:
Endometriosis. When uterine tissue grows outside of your uterus, it can have menstrual cycles as well – this includes the characteristic bleeding that occurs each month. Because this is happening on the outside of your uterus, the blood and tissue becomes trapped inside your abdomen, which can lead to painful cysts and adhesions.
Fibroids. The growths in the uterus can create a feeling of heaviness in your lower abdomen creating pain, especially if they begin to die off.
Irritable bowel syndrome. The symptoms of IBS can cause chronic pelvic pain and pressure that can be very uncomfortable.
Interstitial cystitis. Pelvic pain may occur as your bladder fills and you feel a frequent need to empty it. The pain may temporarily subside after it is emptied, but return again.
Pelvic inflammatory disease. Scarring involving your pelvic organs can build up if you have a long-term infection in this region. Often, the infection was caused by a sexually transmitted disease.
Pelvic congestion syndrome. Enlarged veins around your uterus or ovaries can cause chronic pelvic pain.
Pelvic floor muscle tension. If the pelvic floor muscles are tense or having spasms, it can lead to recurring pain in the pelvic region.
Psychological causes. Being depressed, stressed or experiencing physical or sexual abuse can cause you to experience chronic pelvic pain. The mind, body and spirit are all connected and emotional distress and chronic pain can go hand in hand.
The main thing to remember is that the pain is very real and you’re not alone. One quarter of women with CPP may spend two to three days a month in bed. More than half of all women who have chronic pelvic pain have to limit their activity one or more days a month and 90% experience pain during intercourse.