Chronic Pelvic Pain: Causes and Treatment

According to the Spanish Society of Gynecology and Obstetrics (SEGO), 15% of women suffer discomfort persistent in the perineal region. This circumstance is known as chronic pelvic pain.

The causes can be multiple. Once detected, it is recommended to complement treatment with pelvic physiotherapy to see a significant improvement in the patient's quality of life.

Pelvic floor

The pelvic floor, perineum or perineum is the area located at the bottom of the pelvisSpecifically, it refers to the soft tissues that close the pelvic abdominal cavity downwards. These prevent the pelvic organs from shifting outward and causing genital prolapse.

Pelvic floor dysfunctions

The most common pelvic floor disorders are:

la voiding dysfunction –urinary incontinence-,
la anorectal dysfunction –fecal incontinence or terminal constipation-,
the already mentioned genital prolapse
and the chronic pelvic pain.

When is pelvic pain considered chronic?

For pain in the perineal region to be considered a chronic condition, the discomfort must persist for a period of not less than 6 months.

Chronic pelvic pain encompasses a wide range of clinical conditions. The most notable of these are:

el recurrent or intermittent pain,
la vulvodynia –vulvar pain-,
dysmenorrhea – pain during menstruation
and dyspareunia –pain during sexual intercourse-.

These discomforts can vary in intensity to the point of causing not only relationship problems but also irritability. Therefore, they significantly impair women's quality of life.

Searching for the origin of chronic pelvic pain

The most important thing is that the woman understands that Suffering any type of discomfort continuously is not normal, not even during menstruation. Pain, cramps, pressure, or heaviness in the pelvic floor can and should be avoided. To do this, it is necessary to go to the gynecologist so that, through the relevant tests, the cause can be located. specific cause that originates them.

Most common causes

Endometriosis or the presence of endometrial tissue outside the uterus. It usually causes painful cysts and fibrous bands of scar tissue in the pelvic area. It can also develop in other areas of the body, such as the skin or lungs.

musculoskeletal problems such as fibromyalgia, pelvic floor muscle tension, pubic symphysis or hernias.

Chronic pelvic inflammatory disease If a long-term infection leads to the formation of scars affecting the perineal organs.

Ovarian remains residual cysts that give rise to the appearance of painful cysts after surgery to remove the uterus, ovaries and fallopian tubes.

Fibroids or benign tumors.

Irritable bowel syndrome, irritable bowel or mucous colitis. This is a bowel disease that causes abdominal pain and changes in bowel movements.

Painful bladder syndrome or interstitial cystitis. This condition causes pain in the bladder and a frequent need to urinate.

Pelvic congestion syndrome, caused by the accumulation of blood in the veins of the pelvis, which have dilated and become varicose veins.

Dysmenorrhea o Premenstrual syndrome.

Psychological factors, such as depression, chronic stress, or a history of sexual or physical abuse, may increase the risk of chronic pelvic pain.

How to treat chronic pelvic pain

Due to the multiple causes that can lead to chronic pelvic pain, there is no single treatment. However, all of them can be corrected through pelvic floor physiotherapy –always as a complement to the main treatment-.

Among the most effective techniques we find:

abdomino-pelvic training exercises,
perineal massages,
electrostimulation,
dry needling or Chinese balls
and, above all, the kegel exercises.

Chronic pelvic pain: causes and treatment