Chronic Pelvic Pain

Chronic pelvic pain

What is Chronic Pelvic Pain?

Chronic pelvic pain is not a condition by itself, but rather a symptom in Singapore that could be pointing to several underlying health conditions. Often patients are confused about when they should see a doctor with regards to their pelvic pain. The word chronic, medically, means long-lasting. So if you have pelvic pain that is persistent from anywhere between 3-6 months, it is a good indication that you should get yourself checked.

Chronic pelvic pain can be indicative of issues in your reproductive system, urinary tract, pelvic musculoskeletal issues, cancer, or even psychological causes such as anxiety and depression. Unfortunately, many patients tend to downplay their symptoms of chronic pelvic pain and prolong seeking medical intervention. It is highly advisable to identify the cause of your pain and then explore treatment options to eliminate any possibilities of potentially life-threatening health conditions.

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What are the common causes Chronic Pelvic Pain in Singapore?

As mentioned earlier, a myriad of issues may cause chronic pelvic pain. Below are some potential causes and ways they could manifest as chronic pelvic pain:

  • Gynaecological disorders: conditions such as endometriosis, fibrosis, adenomyosis, fibrosis, and ovarian cysts may all cause chronic pelvic pain. It is important for one to obtain an early diagnosis to preserve their quality of life and avoid potential repercussions such as infertility.
  • Cancers: gynaecological cancers such as cancers of the ovary, cervix, vagina, and endometrium can also exhibit symptoms of chronic pelvic pain. It is also important to detect cancer at its early stages to give yourself the best chance of survival.
  • Urologic conditions: urologic conditions such as urologic pelvic pain syndrome, urinary disorders, and interstitial cystitis may present symptoms of chronic pelvic pain and will require an intervention from a urologist.
  • Pelvic congestion syndrome: also known as pelvic venous insufficiency, is caused by dilated veins that obstruct blood flow and subsequently lead to blood pools in the pelvic veins. The stress on the vein causes cramping and pain in the pelvic area.
  • Irritable bowel syndrome (IBS): IBS may cause pelvic pain as one’s intestines may be highly inflamed. Pelvic pain is seemingly more common in women with IBS compared to men.
  • Psychological disorders: chronic pelvic pain is often seen in patients with mood disorders like depression, anxiety, and bipolar disorder. Some have hypothesised that this is due to non-relaxing pelvic floor dysfunction where excessive stress leads to the contraction of pelvic floor muscles.

What are the symptoms of Chronic Pelvic Pain?

Given that chronic pelvic pain could be derived from a variety of physical and mental issues, symptoms may differ from one patient to another. Chronic pelvic pain may present itself as:

  • Sharp, stabbing pain in the pelvic area
  • Pain that feels like menstruation cramps
  • A dull and achy sensation in the pelvic region that never goes away
  • A tender pelvic region which is painful when pressure is applied
  • Pain when sitting or standing up and relief is only felt when lying down
  • Persistent pain that interferes with your daily life
  • Pelvic pain that disrupts your sleep
  • Pelvic pain which worsens during sex or exercising
  • Pelvic pain that worsens or feels better after urinating or defecating
  • Pelvic pain that worsens during menstruation
  • Sensation of “heaviness” in the pelvic area

If you notice any of the symptoms stated above, make an appointment today to get an accurate diagnosis and effective treatment.

Is Chronic Pelvic Pain painful?

Yes. As its name suggests, chronic pelvic pain is always accompanied by pain – which can be a sharp, stabbing pain, dull achy pain, persistent pain, or intermittent pain.

Who is at risk of Chronic Pelvic Pain in Singapore?

As the root cause of chronic pelvic pain varies, the exact risk factors depend upon one’s diagnosis. Regardless, below are some possibilities that increase your chances of chronic pelvic pain.

  • Family history: if the women in your family have been diagnosed with any form of gynaecological condition or cancer, the chances of you also being diagnosed with one increases, which in turn increases your risk of chronic pelvic pain.
  • Lack of hygiene: various studies have shown an affiliation between poor hygiene and the incidence of infection, cancers, and conditions such as pelvic inflammatory disease (PID).
  • Prior history of sexual abuse and trauma: this is particularly true for women who have experienced sexual abuse and trauma below the age of 15. Chronic pelvic pain may be due to musculoskeletal issues caused by the abuse, a symptom of post-traumatic stress disorder stress and central sensitisation where one is hypersensitive to pain.
  • High-risk sexual behaviours: women with multiple partners and who engage in unprotected sexual activity have increased risks of sexually transmitted diseases which subsequently cause the manifestation of chronic pelvic pain.

How is Chronic Pelvic Pain diagnosed in Singapore?

Chronic pelvic pain can be a difficult condition to diagnose as often healthcare professionals are dumbfounded on the exact cause that is causing the presentation of this symptom. Papers have even gone as far as labelling chronic pelvic pain as a clinician's nightmare.

It is important that your provider is first aware of the various aetiologies as this will ensure the right questions are posed to identify the progression of the symptom. When diagnosing the condition behind chronic pelvic pain, you may be required to undergo the following:

  • Medical review: includes declaring any potential gynaecological disorders or cancers prevalent among your family members, sexual history, urinary and bowel habits and history of abuse or trauma. The medical review is arguably the most important part of diagnosis as it would provide important clues. It is pertinent that patients are honest and transparent in the process.
  • Pelvic examination: a physical assessment for the presence of any palpable growth and to identify the tenderness of your pelvis.
  • Clinical tests: you may be requested to undergo urine, blood, and faecal tests to identify any abnormalities or infections.
  • Imaging tests: pelvic ultrasounds are commonly used to identify any abnormal growth in the pelvic region. Further tests encompassing magnetic resonance imaging (MRI) or X-rays may be requested if closer inspection is deemed necessary.
  • Biopsy: if an abnormal growth is identified, a biopsy may be carried out to examine the tissue of growth in a laboratory.
  • Diagnostic laparoscopy: a non-invasive surgical and diagnostic method which utilises a camera to visualise the pelvic area.
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What are the treatment options for Chronic Pelvic Pain in Singapore?

Depending on the cause of your chronic pelvic pain, the treatment offered may vary, these include:

  • Oral medication: you may be prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) to help alleviate pain and inflammation. These, however, do not treat the underlying condition.
  • Antibiotics: if the underlying cause is an infection, you would be treated with the appropriate cycle of antibiotics.
  • Hormone therapy and contraceptives: if the pain is caused by gynaecological conditions, appropriate hormone therapy would be suggested to control underlying factors such as endometrial spread and fibrosis growth.
  • Surgery: if abnormal growths such as cysts and fibroids are identified, you may require surgery to remove these abnormal growths to provide relief from pain.
  • Antidepressants: mostly explored for women with psychological disorders but may occasionally be suggested as a treatment for women who do not have any psychological disorders. Antidepressants have been clinically proven to improve symptoms.

Frequently asked questions

Can chronic pelvic pain cause back pains?

Yes, in certain patients, chronic pelvic pain is also accompanied by back pain. It is common for the pain to “spread” as there are overlapping nerve pathways, and impact to spine alignment caused by musculoskeletal issues and inflammation can spread to nearby organs.

Can I heal chronic pelvic pain naturally?

If you have attempted to remedy your pain for months, it is only wise to seek medical intervention. Remember, chronic pelvic pain can be a symptom of more sinister conditions. Whilst 3-6 months is the general medical guideline, it is advised to seek medical help if your pain persists even for a month. Pain is an unnatural state to tolerate and early intervention promises prevention of risky health conditions from progressing.

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