Chronic pelvic pain

Chronic pelvic pain is ongoing pain in the lower abdomen or pelvis lasting longer than six months. It is a complex condition and may have more than one contributing cause.

  • Causes of CPP may be summarised as below

    Disorders of pelvic organs-

    • Endometriosis-most common gynaecological cause of CPP

    • Pelvic inflammatory disease – infection of ovaries, fallopian tubes or uterus

    • Adhesions in abdominal or pelvic region

    • Ovarian cysts

    • Retained ovary syndrome

    Urinary tract disorders

    • Abnormal benign growth in bladder

    • Inflammation of bladder lining

    • Inflammation of urinary tract

    Disorders of gastrointestinal tract

    • Chronic constipation

    • Inflammatory bowel disease

    • Irritable bowel syndrome

    • Intolerance to gluten

    Disorders of musculoskeletal system

    • Weakened pelvic or lower abdominal muscles

    • Poor posture

    • Chronic muscle pain with no obvious cause

    In addition to above, there may be several other known causes of the CPP relating to nerve, trauma or back problems

  • CPP can be diagnosed with the help of

    • Physical pelvic examination

    • Abdominal or vaginal ultrasound

    • Blood or urine tests

    • Tests for sexually transmitted diseases

    • x-ray, CT scan or MRI

    Surgical procedures to diagnose CPP include laparoscopy or hysteroscopy

    Sometimes referral to an urologist or gastroenterologist may be required to perform of the checking bladder or bowel.

  • Medications

    Common medical treatment includes

    • Pain relievers, antibiotics, muscle relaxants

    • Antidepressants

    • Oral contraceptives

    Holistic treatments

    Lifestyle changes like reduction in smoking or caffeine intake, dietary improvements may help to reduce symptoms

    Physiotherapy to strengthen the pelvic floor muscles or relax trigger points may help in some cases

    Complementary therapies like massage or acupuncture are also tried by some patients, however there is no supporting evidence and have increased risk of complications.

    Surgical treatments

    Laparoscopy may be used to treat gynaecological problems like endometriosis, pelvic adhesions or ovarian cysts

    Hysterectomy can be useful in certain cases, however rarely used to treat CPP in isolation

    All surgical treatments have their own risks. Please refer to the risk associated with laparoscopy and hysterectomy.

  • RANZCOG Patient Information Guides

    https://www.healthdirect.gov.au/chronic-pelvic-pain

Frequently Asked Questions