What is chronic pelvic pain?
Pelvic pain is considered chronic if it lasts 6 months or longer. It is common and affects around 1 in 6 women. Although many women experience pelvic pain, only a small portion of them visit their doctor to seek treatment. Treatment is very important because chronic pelvic pain also affects overall health. It can be very hard to live with and can cause emotional, physical, social and economic difficulties

What are the symptoms?
Your pain may be mild, or it may be so severe that you miss work, can’t sleep and can’t exercise. You may also experience pain during intercourse; while urinating or having a bowel movement and when you sit for long periods of time. You might describe it as:
• Severe and steady
• Comes and goes
• Dull aching
• Sharp or cramping
• Pressure or heaviness deep within your pelvis

What are the causes?
It is usually caused by a combination of physical, psychological and social factors rather than a single underlying condition, although for many women a definitive cause cannot be found. Common causes include:
• Endometriosis
• Adenomyosis
• Pelvic Inflammatory Disease
• Bladder pain syndrome/interstitial cystitis – a woman might have   both endometriosis and interstitial cystitis. This is known as the ‘evil twins of pelvic pain’.
• Depression, stress or a history of sexual or physical abuse may increase your risk.

When to see a specialist?
In general, make an appointment if your pelvic pain disrupts your daily life or if your symptoms seem to be getting worse. Figuring out what’s causing your pain often involves a process of elimination. In addition to a detailed enquiry taking into account your personal & family health history, your specialist may order a series of tests or examinations including: pelvic exam, laboratory tests, ultrasound and other imaging tests, laparoscopy and cytoscopy.

What treatments may help?
If your specialist thinks that your pain is due to a particular cause then you should be offered treatment. Effective treatments are available for many pelvic conditions. With patience and open communication, you and your specialist can develop a treatment plan that helps you live a full life with minimal discomfort.

Dr. A S Arun MD DNB CCST, FRCOG, FRANZCOG 
Waikiki Specialist Centre
221 Wilmott Drive, Waikiki WA
Phone 9550 0300
Fax 9592 9830
Email specialists@waikikiprivatehospital.com
http://www.doctorarun.com.au