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Chronic Pelvic Pain

Chronic Pelvic Pain Overview

According to various studies, it’s believed that approximately 13-20 million women and girls in the US suffer from chronic pelvic pain (CPP). Yet, despite being one of the most common medical conditions in women and girls, sadly, many suffer for years without receiving an accurate diagnosis or adequate treatment.

Potential Causes of Chronic Pelvic Pain

Endometriosis is one of the most common causes of chronic pelvic pain in women. However, it’s not the only condition that can cause pain in the abdominal/pelvic region: Ovarian remnant syndrome, non-endometriotic ovarian cysts,adenomyosis, ovarian torsion, ovarian hyperstimulation syndrome, adhesions, vulvadynia, chronic obstructive uropathy, fibroids,degenerating fibroids, fibroid torsion, pyelonephritis, fistulas, hernias, post-hysterectomy disorders, appendicitis, inflamed fallopian tubes (endosalpingiosis, salpingitis, etc.), ureterohydronephrosis, post-surgery pain from unrecognized complications, endometritis, adhesion-induced bowel obstructions, post-surgery bowel disorders, abdominal wall disorders, irritable bowel syndrome, severe proctitis, rectovaginal fistulas, rectus sheath hematoma, celiac disease, diverticulitis, colitis, Chrohn’s disease, gastroenteritis, ulcerative colitis, urinary tract obstruction, hydroureter, interstitial cystitis (also called painful bladder syndrome), bladder cystocele (prolapsed bladder),rectocele (prolapsed rectum), other prolapsed organs,neurogenic bladder, other neurogenic pain, other genitourinary disorders, pain from the muscles of the abdominal wall, bladder, or bowel, other pain from other muscles or joints (myofascial pain), pelvic floor disorders, pudendal neuralgia, , urethral disorders, ectopic pregnancy, post-childbirth complications, pelvic inflammatory disease (PID), other infections, chronic pelvic pain syndrome, endometrial hyperplasia, cervical stenosis, irradiation damage, infected or displaced intrauterine device (IUD), gynecologic malignancies, and many other conditions can be associated with chronic pelvic pain or co-exist with endometriosis.

Suffice it to say, this is certainly an unwieldy list, and, it isn’t even comprehensive! With so many potential disorders to sort through, this is why we encourage you to seek out a chronic pelvic pain specialist with expertise in recognizing these and dozens of other disorders that may be contributing to your pain.

Common myths still circulating

It’s also important to seek out a specialist because there are still many misconceptions about chronic pelvic pain in women and girls. For example, some non-specialists don’t realize how painful adhesions or adenomyosis can be or wrongly assume that endometriosis cannot cause upper abdominal pain or severe back pain. Endometriosis of the vagus nerves or vagus nerve damage caused by abdominal laparotomies are also other causes of pelvic pain that are often overlooked as sources of chronic pelvic pain. Teenagers and pre-teens with chronic pelvic pain also deserve special care and attention. A significant number of adolescents with pelvic pain have endometriosis. However, many girls suffer for years without a diagnosis because well-meaning family members, friends, school nurses, and even many doctors may interpret the typical symptoms of endometriosis as normal. Adolescent girls that suffer from severe menstrual cramps, miss school, or are deprived of their usual activities during menses need a thorough investigation to rule out endometriosis. An early diagnosis confirmed by diagnostic laparoscopy and biopsy can spare girls from years of unnecessary suffering, potentially prevent irreversible organ damage, and preserve their fertility.

Living with chronic illness

Living with a chronic illness like CPP is devastating. Not only is it emotionally and physically exhausting, but because CPP is often misdiagnosed, resistant to treatment, or even believed to be “all in your head”, many women end up feeling a sense of crushing hopelessness about their chances of returning to a normal, pain-free life.

Yet, making matters worse is the fact that pinpointing the cause or causes of chronic pelvic pain is sometimes difficult for non-specialists to do. In fact, the International Pelvic Pain Society estimates that approximately “61% of women suffering from chronic pelvic pain don’t know what is causing it.”  As a result, women sometimes have to see dozens of doctors for years before someone finally figures out what’s wrong.


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