Chronic Pelvic Pain (CPP) – Causes, Symptoms, Diagnosis, and Treatment

Introduction

Hello, I am Dr. Indira Sarin, I know many of you have been suffering from pain in your lower abdomen for months or even years. Some of you may think, “Oh, it’s just normal period pain” or “Maybe I’m just tired.” But let me be very clear—pain that lasts for six months or more is NOT normal! It is time to stop ignoring your discomfort and start taking your health seriously.

As a doctor, I see so many patients who delay seeking medical help, thinking their pain will go away on its own. But by the time they finally visit me, their condition has worsened. Please don’t make that mistake. If you have ongoing pelvic pain, it’s time to understand what’s happening in your body.

What is Chronic Pelvic Pain?

Chronic Pelvic Pain (CPP) is a persistent pain that occurs in the lower abdomen or pelvic region and lasts for six months or longer. It is different from the occasional discomfort you may feel during your period or after eating certain foods. This pain can be dull, sharp, burning, cramping, or a combination of these.The pain might be constant or come and go at different times, making it unpredictable.

Many women experience this pain, but they don’t talk about it because they think it’s “just part of being a woman.” That is WRONG. Pain is not something you should live with. If you are experiencing pelvic pain that doesn’t go away, it is a sign that something is wrong, and we need to find out what it is.

What Are the Symptoms of Chronic Pelvic Pain?

Now, I want you to pay attention to this part. Many of you ignore these symptoms, thinking they are minor, but they are NOT. If you experience any of the following, you need to see a doctor immediately:

Constant or recurring pain in the lower abdomen or pelvic area
Pain that worsens during your menstrual cycle
Pain during or after sexual intercourse
Burning or discomfort while urinating
Painful bowel movements or constipation
A heavy, aching feeling in the pelvic region
Sitting or standing for too long can worsen the discomfort, making movement difficult.
Pain that interferes with your daily life and activities

Many of my patients tell me, “Doctor, I thought it was normal,” or “I thought it would go away.” But let me tell you—when pain starts affecting your quality of life, it is NOT normal!

What Causes Chronic Pelvic Pain?

Now, let’s talk about what could be causing this pain. There is no single reason for CPP—it can be caused by multiple factors, and sometimes, it is a combination of different issues. Instead of assuming the cause, it’s always better to consult a doctor for an accurate diagnosis.

Gynecological Causes (Common in Women)
- Endometriosis: Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus, causing pain and swelling.
- Pelvic Inflammatory Disease (PID): Pelvic Inflammatory Disease (PID) is a bacterial infection in the reproductive organs, often linked to untreated STIs.
- Uterine Fibroids or Ovarian Cysts: These non-cancerous growths can cause pressure, bloating, and pain.
- Adenomyosis: Adenomyosis happens when the uterine lining invades the muscle layer, leading to intense cramping.
- Painful Periods (Dysmenorrhea): Some women have extremely painful menstrual cycles due to excessive contractions of the uterus.
Urinary Tract Causes:
- Interstitial Cystitis (Bladder Pain Syndrome): A chronic bladder condition that causes frequent urination and pelvic pain.
- Urinary Tract Infections (UTIs): If left untreated, repeated infections can lead to chronic pelvic pain.
Digestive System Causes:
- Irritable Bowel Syndrome (IBS): Irritable Bowel Syndrome (IBS) causes digestive issues like bloating and constipation, often triggering pelvic discomfort.
- Chronic Constipation: Straining and pressure on the pelvic organs can lead to pain and discomfort.
Musculoskeletal Causes:
- Pelvic Floor Dysfunction: If the muscles that support your pelvic organs become weak or too tight, they can cause pain.
- Hernias: Abnormal bulges in the abdomen or groin can cause discomfort and chronic pain.
Neurological Causes:
- Nerve Damage (Neuropathy): When nerves in the pelvic region become irritated or compressed, they can cause long-term pain.

How is Chronic Pelvic Pain Diagnosed?

Listen to me carefully—you CANNOT diagnose yourself by searching on Google! To find the cause of your pain, a doctor needs to examine you properly. Here’s what I do when you come to my clinic:

Medical History: I will ask about your symptoms, past medical conditions, surgeries, menstrual cycles, and lifestyle.
Physical & Pelvic Exam: I will check for any visible abnormalities and signs of infection.
Lab Tests: Blood and urine tests can help rule out infections and other health conditions.
Ultrasound, MRI, or CT Scan: These imaging tests help detect fibroids, cysts, or other internal abnormalities.
Laparoscopy: In some cases, I may recommend a small surgical procedure to look inside your pelvis and confirm conditions like endometriosis.

Skipping these tests WILL NOT make your pain go away! The sooner we diagnose the problem, the sooner we can treat it.

Treatment of Chronic Pelvic Pain

Now, let’s talk about treatment. Some of you want a magical cure, but let me be honest—chronic pain takes time to manage, and treatment depends on the cause.

Medications

Pain Relievers (NSAIDs): Help reduce inflammation and pain.
Hormonal Therapy: Birth control pills or hormonal IUDs help balance hormone-related conditions.
Antibiotics: If an infection is responsible for the pain, antibiotics are prescribed to eliminate the bacteria.
Nerve Pain Medications: If the pain is due to nerve damage, special medications can help.

Physical Therapy

Diet Adjustments: Avoiding spicy foods, caffeine, and processed foods can help.
Exercise & Stress Management: Regular movement improves blood flow and reduces pain.

Surgery (If Needed)

Laparoscopic Surgery: To remove endometriosis, fibroids, or cysts.
Hysterectomy (Rare Cases): Removing the uterus if all other treatments fail.

Final Words from Dr. Indira Sarin

Let me say this one last time—DO NOT IGNORE PERSISTENT PELVIC PAIN! It is not “just stress” or “normal period pain.” Pain that lasts for months could mean a serious health issue, and delaying treatment will only make it worse. You deserve to live pain-free, so stop waiting and take action now. Come for a consultation, get the right diagnosis, and start your treatment. The sooner we find the cause, the sooner we can help you feel better. Your health is important—don’t suffer in silence!

Frequently Asked Questions

What position relieves pelvic pain?

“Propping your knees with a pillow while sitting can reduce pelvic pressure. Lying on your side in a fetal position helps relieve tension in your lower back and pelvis. Gentle yoga stretches like the ‘cat-cow’ pose can also ease discomfort. Finding a position that relaxes your muscles without straining them is key. Listen to your body and adjust for comfort.”

Does walking reduce pelvic pain?

“Yes, gentle walking improves blood circulation, reduces stiffness, and helps with inflammation. It can ease tension in pelvic muscles and improve flexibility. However, if the pain is severe, rest and seek medical advice before engaging in physical activity. Short, slow walks can also boost your mood and overall well-being. Always listen to your body and avoid overexertion.”

Can pelvic pain be cancerous?

“Most pelvic pain is not cancer-related but is often due to conditions like endometriosis, infections, or fibroids. However, persistent or unusual pain should never be ignored. A proper medical evaluation helps rule out serious conditions, including cancer. If your pain is worsening, changing, or accompanied by other symptoms, consult a doctor. Early diagnosis ensures timely and effective treatment.”

Which fruit is good for pelvic pain?

“Berries like strawberries and blueberries are rich in antioxidants and help reduce inflammation. Pineapple contains bromelain, which has natural pain-relieving properties. Apples and pears are high in fiber, aiding digestion and preventing bloating, which can worsen pelvic pain. Bananas provide magnesium, which helps relax muscles. Eating a variety of fresh fruits supports overall health and pain management.”

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Chronic Pelvic Pain