Chronic pelvic pain (CPP) is most often seen in adult white women and is defined as any pelvic pain that continues for more than six months. CPP can be identified clinically by six common characteristics:

• Duration of six months or longer
• Incomplete relief with most treatment
• Significantly impaired function at home or work
• Signs of depression (e.g. early morning awakenings, weight loss,
    anorexia)
• Pain out of proportion to pathology
• Altered family and social roles

Activities such as changing position, sitting or standing for long periods, and exercise can trigger pain. Rectal itching and burning on when having a bowel movement associated with irritable bowel syndrome (IBS) are other typical symptoms. Other medical conditions that may present as chronic pelvic pain syndrome include interstitial cystitis, overactive bladder (OAB), and urethral syndrome.

Irritable bowel syndrome and other colorectal problems may also give rise to symptoms that mimic CPP, and may even coexist to produce a confusing overall picture. CPP often encompasses psychological and environmental factors along with a collection of physical factors. Because a single concise cause is rarely identified, treatment of just one aspect of the syndrome will not necessarily produce a cure.

Studies have shown that women with CPP are more likely to have a history of sexual abuse compared to other groups of women. These women are often referred to many different specialists and, in the process, they may be subjected to expensive tests and exploratory surgery only to be told that ’nothing is wrong’ because no underlying pathology was discovered or identified.

Many women consent to hysterectomy or other major surgery and still experience pain. CPP is often intractable and unremitting and may lead to lifestyle changes that affect work, recreation and personal relationships. An integrated multidisciplinary team approach to treatment is often the best way to give the woman the greatest chance of a long-term cure.

Typical symptoms of Chronic Pelvic Pain in Women:

• Anxiety and depression.
• Involuntary contractions (spasms)of the levator ani and perineal muscles can lead to pelvic pain and is called vaginismus. This condition is often called pelvic floor tension myalgia and is accompanied by painful and difficult penetration of the vagina.
• Fatigue, both mental and physical.
• Rectal itching.
• Burning during the frequent bowel movements associated with Irritable Bowel Syndrome.
• Sleep interruptions.
• Low back pain and a feeling of heaviness in the lower abdomen.
• Leg pain that radiates from the groin.
• Constipation or diarrhea.
• Irregular or painful menstrual cycles.