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Chronic pelvic pain is the most common reason for women to
be referred to a gynaecology clinic, and the most common reason for
men under 50 to visit a urologist.
It can affect both men and women, although women are much more likely
to consult a health care professional about the problem.
Chronic pelvic pain affects approximately 15% of women aged
There are a large number of causes of pelvic pain. These
can be related to the organs in the pelvis (like the bladder, or the uterus and
ovaries in women), the muscles of the pelvic floor, or the nerves of the pelvis
and low back.
Some of the more common chronic pelvic pain conditions are:
Other pelvic pain conditions may include:
- Disorders of the bowel such as Irritable Bowel Syndrome
- Previous abdominal surgery or infection that has resulted
Musculoskeletal/myofascial pain (pain that arises from
bones, joints, or muscles in the abdomen or pelvic floor or referred pain from
other areas that produces felt pain in the abdomen or pelvic
cystitis produces recurring discomfort in the bladder and pelvic
area. The symptoms vary between individuals, however some people can experience
intense pain. Pelvic
pain may increase with a full bladder, when urinating,
during periods or while having sex. Like regular cystitis,
interstitial cystitis can create an urgent and frequent need to urinate. The
condition doesn't respond to treatment with antibiotics as it is not caused by a
bacterial infection. Both men and women can get
interstitial cystitis, although the vast majority of cases
are in women.
Get more information from National Health Services [UK].
Prostatitis is an
infection or inflammation of the prostate gland.
different types of prostatitis:
- acute bacterial prostatitis
- chronic bacterial prostatitis
- non-bacterial prostatitis
- chronic pelvic pain syndrome (CPPS) – also called pelvic floor
myalgia or prostatodynia
Get more information from the Canadian Cancer Society.
to pain or discomfort involving the vulva (the genital area between the legs and
outside of the vagina). Symptoms include uncomfortable sensations such as
burning, stinging, irritation, stabbing, or rawness. When no other obvious
causes (e.g., skin conditions, infections, or diseases) can be found
these symptoms may indicate vulvodynia..
Women who suffer from vulvodynia may find that the discomfort interferes
with daily living activities including wearing clothes, sitting, or walking
and or sexual activities.
Get more information from the Vancouver General Hospital Multidisciplinary Vulvodynia Program.
Dysmenorrhea (menstrual cramps)
Just before and during
their menstrual periods, many women experience menstrual
cramps or dysmenorrhea.. Dysmenorrhea
is an extremely common and sometimes debilitating condition for women of
- Throbbing or cramping pain in your lower abdomen that may be
- Dull, constant ache
- Pain that radiates to your lower back and
Get more information from the Society of Obstetricians and Gynecologists of Canada and Canadian Pain Coalition
Endometriosis is the growth of excess tissue, similar to the kind that lines
the uterus every month, and elsewhere in your abdomen. This excess tissue
responds to your menstrual cycle each month. When the tissue breaks down, it can
lead to inflammation, causing pain. Common sites for endometrial growth are the
ovaries, on the uterus and behind the uterus. It can also be found on the
bladder, rectum and intestines.
- Atypical menstrual pain: starting a few days before your period and lasting
throughout your period, or which is very severe
- Chronic pelvic pain, which may also be associated with sex
- Painful urination during periods
- Bowel problems (such as diarrhea, constipation and pain)
- Difficulty conceiving
Get more information from the Society of Obstetricians and Gynecologists of Canada
Irritable Bowel Syndrome
Irritable bowel syndrome (IBS) is
a group of symptoms—which includes both pain or discomfort in ones abdomen as
well as changes in ones bowel movement patterns.These changes in
your bowel movement patterns includes how often you have bowel movements or how
your stools look. Doctors aren’t sure what causes IBS.
Get more information from NIH, International Foundation for Functional Gastrointestinal Disorders, and HealthLinkBC
Musculoskeletal / Myofascial Pelvic Pain
pain in women may have a number of factors involved rather than a single
cause, but studies have shown that 22% of chronic pelvic pain
conditions have pain associated with musculoskeletal causes. Pelvic
musculoskeletal dysfunction however is not routinely evaluated as a cause of
pelvic pain by gynecologists. A pelvic musculoskeletal examination is an
important component to investigate in chronic pelvic pain patients.
Myofascial pelvic pain is a frequently unrecognized and untreated
component of chronic pelvic pain. Between 14% and 23% of women
with chronic pelvic pain may have myofascial pelvic pain. Some studies say this
may be as high as 78% among women with interstitial cystitis. In a
recent review, researchers found that very few providers actually perform a
vaginal digital palpation of pelvic floor muscles during routine gynecological
exams to examine for the presence of myofascial pelvic pain and trigger points.
Get more information from Recognizing Myofascial Pelvic Pain in the Female Patient with Chronic Pelvic Pain, in Journal of Obstetric, Gynecologic, & Neonatal Nursing, and Musculoskeletal Causes of Chronic Pelvic Pain: What a Gynecologist Should Know, in Obstectrics & Gynecology