Ladies, this is the WORST. Am I right? The good news is that for MOST of us there is a path to becoming whole again, which is not to say that your pain will go to 0/10 BUT that we can attack the source and deal with it to get you to a life worth living again.
Our conversation must begin with the beginning…and you must be able to have this dialogue with your doctor in order to get to the root of your pain. There are so many causes for pelvic pain — but what gets you the diagnosis of “chronic pelvic pain”??
Chronic Pelvic pain is:
- any pain lasting for > 6 months
- the pain can be located to your pelvis – the area located between and below your hip bones, or can be in your vagina or just outside of your vagina
- the pain can be constant or can come and go
- the pain can be varying levels of intensity
- sometimes you can take Tylenol or Mortin or use a heating pad and it’ll get better and sometimes you can try all of the usual things and the pain does not get better
- sometimes the pain is with sex (either in your vagina or deeper in your pelvis) and sometimes you can enjoy sex without pain
- the pain may start in one area at one intensity and this may change with time, getting worse and sometimes better
Why is it important to distinguish between “pelvic pain” and “chronic pelvic pain” (CPP)?
#1
There are a LOT of temporary things that can cause pelvic pain – for instance, your period; or an ovarian cyst (it’s your ovary’s job to make a cyst every month, your two ovaries typically “take turns” producing an egg in a cyst and, if you do not get pregnant, that cyst typically goes away – when it does not, it may cause pain and menstrual problems – or you may be pregnant and the pregnancy may be in an abnormal place, such as your Fallopian tube – this is called an “ectopic pregnancy” – (we’ll get to this in future posts)
#2
Once you have long-standing symptoms (>6 months), we have interventions to help you – this can include a birth control pill (BCP) (good for menstrual pain as well as for women who have issues with pain sometimes but not always with ovarian cysts – BCPs can inhibit ovulation and the formation of future persistent ovarian cysts); minor surgery to help “fix” a persistent ovarian cyst, or to remove a uterine fibroid (more on this in later posts!); the insertion of an IUD (intra-uterine device) in clinic which can really help relieve heavy bleeding as well as the cramping and pain that can accompany heavy bleeding
Your Doctor will want to know:
- When did the pain start?
- What was happening in your life at that time?
- Where is your pain?
- Describe your pain (burning, stabbing, throbbing, pressure-like, constant, intermittent, related to what?)
- What makes your pain feel better?
- What makes your pain worse?
- Does your pain radiate / travel to other parts of your body?
- Do you have pain with sex? Is it in your vagina or deep in your pelvis? Is it positional?
- Do you have pain with urinating? If so, where is the pain?
- Do you have pain with bowel movements? If so, where is the pain?
- Is your pain related to your period? Only with your period?
Your Doctor may want you to complete a Pain Diary and may have more questions about your pain
The options that we have to treat your symptoms are directly related to the length of time you have been experiencing them, where exactly you are having pain, the relation of your pain to your period, and the relation of your pain to other details of your life.
We know that Chronic Pelvic Pain can be a complicated beast to tackle and there are often MANY avenues to treatment.
We also know that some women who have Chronic Pelvic Pain have a history of painful trauma – sometimes this is sexual trauma, sometimes it is other physical trauma – it can be psychological or emotional trauma – and we are very complicated creatures.
The relationship between trauma and pain is not an easy one to attack or vanquish – when you are able to have a transparent and honest conversation with your provider you will be on the right track to heal and relieve your physical pain.
There are also many women who have NO history of trauma, and who have significant chronic pelvic pain.
Now, all of this does NOT mean that Chronic Pelvic Pain is “all in your head”…what it DOES mean is that…did I mention we are complicated creatures??
We all have a definite and well-established connection between our mind, body, soul, spirit…we are a combination of our life experiences, our physical maturation and body function, our spiritual health and our psychological resilience.
We need to be able to have honest conversations with our doctors to get to the root of our own unique, individual symptoms so we can deal with them in unique, individual ways.
If you are not able to have this kind of conversation with your provider, FIND A NEW PROVIDER!!
I have mentioned only a few of the underlying issues that can cause Chronic Pelvic Pain and only a few of the interventions available to us to treat you and get you back to fighting trim.
In future blog posts and podcasts, we will delve deeper into this topic and answer specific questions that you may have.
Please see below to share your questions and comments for me to address in future posts.
Thank you for sharing time with me, I look forward to hearing from you soon!
And remember to Listen, Be Present, and Believe!
