By: Diana Barnes-Brown for Uterus1
Many women in the United States suffer from chronic pelvic pain, but fewer of these tend to persist in seeking diagnoses and cures for their symptoms, say experts. However, with appropriate treatment of the underlying health problems that cause the pain, the prognosis for sufferers is often very good.
| If you think you may suffer from chronic pelvic pain, you may be helped by putting together a list of questions to ask and information to share with your doctor before you find yourself sitting in the office. Here are some points to keep in mind: If you have pain, what kind of pain is it? Where is it? What does it feel like? Being as specific as possible may help your doctor pinpoint areas of the body that need more attention or testing.|
Be honest about the level of disruption your pain causes. Do you have trouble participating in family activities? Problems making it to work regularly? Are you reluctant to go on outings with friends or loved ones for fear that your symptoms will cut the fun short?
Do you experience sadness, hopelessness, loss of interest in once-exciting activities, sleep disturbances or irritability as a result of your pain?
How long have you suffered from your current symptoms?
Is there anything in your history that your doctor might not know about, and that might help her make a diagnosis, such as repeated miscarriages, a history of pelvic inflammatory disease, uterine fibroids or prior abdominal surgery?
Do you have any hunches about what might be causing your pain?
Be sure to share your thoughts, concerns, and suspicions with your doctor, because you stand a better chance of getting the help you need if you can be completely honest about your medical background and the extent of your current symptoms.
Chronic pelvic pain is defined by the International Pelvic Pain Society as pelvic pain that has been present for at least six months, significantly compromises mobility, contributes to depressed mood and low energy levels, and may interfere with relationships at home and at work. In addition, the pain experienced is frequently “out of proportion” to the amount of abdominal disturbance or tissue damage of contributing underlying conditions, and conventional treatments have done little to help reverse patients’ symptoms.
According to experts in women’s health, about 15 percent of women between the ages of 18 and 50 suffer from the condition, and most remain undiagnosed. But this need not be the case, argue many health care experts.
Chronic pelvic pain involves a number of conditions, some of which do not directly involve the pelvic region. Endometriosis and interstitial cystitis are common culprits of the condition, but other related conditions include vulvodynia, pelvic inflammatory disease (PID), irritable bowel syndrome (IBS), abdominal scarring, fibromyalgia, chronic fatigue syndrome, and temporomandibular joint (TMJ) condition, despite the fact that some of these ailments have little direct connection to the reproductive tract or abdominal region. Some studies have also linked prior sexual abuse or rape to higher risk levels for chronic pelvic pain. Many women who suffer from chronic pelvic pain may have normal physical exam, adding to frustration about what exactly is causing their suffering.
One realization that is currently being made by a number of women’s health specialists is that women who show little pathology may still suffer from a lot of pain and discomfort. Often times, the tests and examinations will say one thing – that there is “no cause” of pelvic pain – while women continue to suffer severe pain and other disruptive symptoms that tell them the tests must be missing something.
Doctors are starting to recognize these phenomena. According to Paul Perry M.D., the founder and board chairman of the international Pelvic Pain Society, part of the explanation is a neurophysiological process called CNS upregulation, in which chronic pelvic pain causes increased sensitivity in cells responsible for transmitting sensations of pain. According to Perry, if underlying causes are not treated in time, chronic pelvic pain may become a serious disease that is difficult to treat, because the pain sensitivity of the cells involved will have already led to chronic pelvic pain syndrome.
Other specialists think that different factors may be to blame, such as inflammation. According to these caregivers, treating the inflammation may lead to the disappearance of pain symptoms.
Sugar and allergies may also be a culprit: over-consumption of sugar can lead to yeast infections with the common organism candida, and both food and cosmetic allergies can cause localized pain in the vulva and vagina.
In other cases, prior psychological trauma, such as rape or sexual abuse may be factors. Many doctors and researchers hypothesize that because sex may have been associated with pain and intense feelings of violation in the past, these feelings may persist for victims long after the abuse itself has stopped. However, it is difficult to find biological explanations for such phenomena, making it more difficult to treat this category of patients successfully. Sometimes, treating depression or anxiety related to prior abuse can help.
Another approach is treatment with so-called “alternative” therapies including acupuncture, yoga or massage therapy. Preliminary research on each of these therapies has suggested that each may be effective in combating certain types of pain, and patient testimonials often confirm the same, but some researchers are awaiting more concrete data before recommending such therapies for treatment.
Given the many possible causes of pelvic pain, it is important for doctors and caregivers to delve into patients’ medical past and personal histories in order to better equip themselves to make an accurate diagnosis. Since chronic pelvic pain is at times an indicator of a more severe illness, it is also important that women do actively seek diagnosis, troubling and frustrating as this process may be at times, to avoid a more serious diagnosis – such as that of cancer or chronic reproductive disease – down the line. With vigilance, however, women and their caregivers will often be able to get to the root of chronic pelvic pain, and from there, treatment is a much easier process to begin.