Chronic Pelvic Pain (CPP)?

What is Chronic Pelvic Pain (CPP)?

  • Noncyclicalpain (not occurring during menses period every month)usually for more than 6 months in lower abdomen.
  • This characteristic dull aching paincondition is also called PCS (Pelvic Congestion Syndrome)
  • Most commonly seen in women between 20-45 years of age.
  • Pain usually worsens by sitting, standing, at the end of the day, during or after intercourse (medical term- Dyspareunia) or sometimes just before the onset of menses.
  • Affected women may also feel urinary frequency, depression, vaginal discharge or discomfort while passing stools.

Why does it happen?

  • Multiple factors can lead to CPP and PCS (Pelvic Congestion Syndrome).
  • It is thought to be due to ovarian and pelvic varicosities (just like the leg pain resulting in 'varicose veins').Multiple pregnancies and weight gain usually result in these veins gets dilated.

What should be done?

  • The standard workup includes
    • Whole Abdomen Ultrasound Scan with Trans-vaginal / Trans-rectal Ultrasound and Doppler study.
    • Pap Smear
    • Routine blood / urine tests.
  • Once these tests show show abnormal results then further specialized tests eg – CT / MRI – Venography etc can be planned if needed by your health care specialist.
  • Pelvic ultrasound is usually the 1sttest as it gives excellent resolution of uterus, ovarian and surrounding areas.
  • Ultrasound might show cystic ovaries suggesting PCOD (polycystic ovarian disease) pattern but since women who come with this paindo not show PCOD symptoms like having irregular periods or increased facial hair clinicians usually rule PCOD out. This most likely cause of Pelvic Congestion Syndrome is estrogen hormone imbalance.

Can it be treated?

Yes, there are medicines to cure this condition. Medical treatment includes psychotherapy anti – inflammatory and hormonal drugs for 3-6 months. Consult your health specialist once you are diagnosed with PCS for further management.

Importance lies in the correct and timely diagnosis of this painful condition to be treated completely.

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