Chronic Pelvic Pain (CPP) is any pelvic pain that lasts for more than six months and occurs in the pelvis or lower abdomen. Sometimes the cause of the pain is not obvious. At other times, the problem, which originally caused the pain, has lessened or even gone away completely, but the pain continues.
Chronic pelvic pain is one of the most common health care problems in our society. It is estimated that 25 million women suffer from chronic pelvic pain. Approximately 25% of women with CPP may spend 2-3 days in bed each month. More than half of the women with CPP must cut down on their daily activities one or more days a month, and 90% have pain with sex. Almost half of the women with CPP feel sad or depressed some of the time.
How is CCP diagnosed? Your health care provider will take a thorough history of your problem. It is very important to give your physician a detailed and accurate description of the problem. The health care provider will also do a physical examination. After this, the health care provider will be able to determine what lab tests and procedures might be needed to find the reasons for your pain.
You can do a number of things to help your health care provider diagnose and treat you. First, get copies of your medical records, including health care provider visits, lab tests, x-rays and surgical testing (if you have had surgeries, records of the surgical treatments). Carefully fill out the health care provider’s questionnaire if provided. Take your time and try to remember all the details and the order in which they happened. Just filling out the questionnaire may help you remember details you had forgotten. Also, it may easier to write out personal information that is difficult or embarrassing to talk about. Remember that the more information you give the health care provider, the easier it will be for them to help you.
Factors that may be very important in your care are:
o How and when did your pain begin?
o What actions or activities make it better or worse?
o Does it vary based on time of day, week or month?
o How does your menstrual cycle affect the pain?
o How does the pain affect your sleep?
o Has the pain spread since it began?
o Do you notice abnormal skin sensations (pain, itching, burning), muscle, joint pain or back pain?
o Do you have pain with urination, constipation, diarrhea or other problems with your bowels?
o Has the pain caused emotional changes like anxiety or depression?
o What have you done to relieve the pain? What has worked? What has not worked?
o What medical treatments have you had? Have they helped?
o What medications have you used in the past? What medications are you taking now?
o What do you think is causing your pain?
o What concerns you most about your pain?
Your health care provider will do a very thorough physical exam. Remember that your pelvis is very important, not only for containing your organs but also because it provides support for your upper body and connects the upper body to the lower body. If needed, an examination of the vagina will be done. The provider may also do a rectal examination but only if needed. Throughout all this, your health care provider will be looking for clues of damage or disease, which might have started the pain, and clues to which nerves are contributing to the pain.
Jodi Bollenbacher, PA-C, Physician Assistant
Blanchard Valley Obstetrics & Gynecology
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