Chronic pelvic pain (CPP) is pain that lasts for more than six months and affects one in seven women.
It can be difficult to treat CPP and it is estimated that one in five women will have recurrence of symptoms within five years.
There are a number of primary pain factors that may result in CPP. These include endometriosis, adenomyosis or infections. While pain usually indicates specific injury to some part of the body, CPP is very different. Often the initial problem is addressed, or the severity of the symptoms lessened, but the pain persists because of changes to the nervous system, muscles or other tissues. For instance, you often feel muscles tense when you have been injured around the area of trauma. Similarly, local disturbances occur in the pelvis, affecting the bowel, bladder, muscles, connective tissue and nerves of the pelvis (the secondary pain factors). Often these secondary factors become the predominant problem, overshadowing the original disease process which may no longer be detectable.
The symptoms of CPP are variable and do not always correspond to the severity of disease. Symptoms may include pain with periods, ovulation or, intercourse, pain when passing urine or opening bowels, or lower back pain.
Unfortunately, there is no simple diagnostic test for CPP. The initial focus is usually on the original source of injury, if there is one, as well as secondary factors through your personal medical history, examination and information from your previous health care providers. Often further investigations will be requested, and we may suggest you keep a personal “Pain Diary”. In some cases, laparoscopic surgery will be recommended to investigate and treat symptoms.
When pain evolves over a long period of time and when there are multiple problems, the treatment for some may be a long-term process. The primary factor that caused your problem, although important to identify and treat, may evolve into a minor issue, with secondary factors becoming more important. Therefore, it is important to that all factors are treated.
At Eve Health we strongly believe that the best treatment results come from a multi-disciplinary approach to women’s health care. Your Eve Health gynaecologist may work with our pain physicians, physiotherapists, psychologists and other specialties as required.
If you think you may be experiencing some of these symptoms, please ask your GP to consider referring you to an Eve Health gynaecologist for further assessment and investigation. Eve Health have a strong history of dealing with the “too-hard” cases that are referred from other practitioners and our team approach is popular with women.
If you would like further information the Pelvic Pain Foundation of Australia is an excellent resource www.pelvicpain.org.au/