Pelvic Pain Disorders & Chronic Pelvic Pain

Pelvic pain can be felt in any area related to a person’s pelvic floor or sex organs, including the vagina, uterus, lower abdomen, perineum, rectum, anus or the tailbone.

While some pelvic pain can come on suddenly as a result of an infection or another condition, CPP is any pelvic floor pain that lasts for six months or longer.

The following are some examples and causes of pelvic pain:

• Coccydynia – tailbone pain.
• Cystocele, or prolapse of the bladder, characterized by the dropping or bulging of the bladder into the vagina.
• Diastasis recti – separation of the abdominal muscles.
• Dyspareunia – painful intercourse . Any number of issues can lead to sexual pain, or dyspareunia, including back, bladder or bowel pain.
• Endometriosis – a disorder in which the cells from the lining of the uterus grow outside of the uterus.
• Fibromyalgia – chronic pain throughout the body causing tenderness in the muscles, joints, and tendons. This disorder has also been called Chronic Fatigue Syndrome.
• Interstitial cystitis (IC) chronic inflammation of the bladder lining that causes bladder pain and frequent, urgent urination.
• Irritable bowel syndrome (IBS) a complex and common disorder that affects the lining of the colon and can cause spasming, cramping, gas, bloating, constipation or diarrhea.
• Neurogenic bladder – bladder disorders that arise due to problems with the nerves that control the bladder.
• Neurogenic bowel dysfunction – bowel disorders that arise due to problems with the nerves that control the bowel.
• Nocturia – waking frequently to urinate (most people can sleep 6-8 hours with minimal need to wake (0-1 times).
• Overactive bladder (OAB) – a urologic condition categorized by frequent, strong urges to urinate during the day or night.
• Pelvic organ prolapse – the encroachment or bulge of the bowel, bladder or uterus into the vaginal canal.
• Pudendal nerve entrapment (PNE) – a sacral nerve that dives through the buttock and hip region on both sides of the body. This is a nerve that affects bowel, bladder and sexual function. Entrapment or irritation of this nerve can cause an array of symptoms including deep pelvic/ hip/ buttock pain, as well as bladder or bowel urgency, tightening or spasms of the pelvic muscles, vulvar pain, painful intercourse, extreme pain or difficulty with sitting, and many other related disorders.
• Vaginismus – a condition in which involuntary contractions of the muscles surrounding the vagina (pelvic floor muscles) occur during attempted intercourse.
• Vulvar vestibulitis – pain and inflammation of the tissue between the labia minora and the vaginal opening.
• Vulvodynia – a vulvar burning pain occurring in the absence of relevant visible findings or a specific, clinically identifiable neurologic disorder.

Because many disorders can cause pelvic pain, diagnosing the cause of your pain may take time. Your doctor will ask you about your personal health history and your family history, and you may be asked to keep a journal of your pain and other symptoms. Additional tests your doctor might suggest include:

• Pelvic exam to look for signs of infection, abnormal growths or tense pelvic floor muscles.
• Lab tests to determine if you have an STD, STI or other infection.
• Imaging to detect masses or cysts in the ovaries, uterus or fallopian tubes.
• Laparoscopy, a minimally invasive surgical procedure that allows your doctor to view your pelvic organs and check for abnormal tissues or signs of infection.

Treatment for pelvic pain is often based on the cause of your pain. Treatment options can include:

• Pelvic floor physical therapy
• Injections
• Medication
• Vaginal pessary
• Nerve stimulation
• Surgery

The Hoag Pelvic Health Program offers a team of dedicated physical therapists who specialize solely in pelvic floor conditions and partner with urologists, gynecologists and other pelvic health subspecialists. The program’s unique approach also offers integrative wellness therapies provided by credentialed practitioners in acupuncture, sexual health counseling, Pilates, guided imagery and massage therapy. Learn more about our Pelvic Health Program here .