Chronic Pelvic Pain

What Is Chronic Pelvic Pain?

Chronic pelvic pain (CPP) is persistent pain in the lower abdomen or pelvis lasting 6 months or longer. It affects both men and women and often involves multiple body systems. CPP can have significant impacts on quality of life, relationships, and work.¹

Symptoms²

Constant or intermittent pelvic pain
Dull aching or sharp pain
Pain during intercourse
Pain with urination or bowel movements
Pain with sitting
Low back pain

Possible Causes

In Women

Endometriosis
Adenomyosis
Interstitial cystitis
Vulvodynia
Pelvic inflammatory disease
Ovarian cysts

In Men

Chronic prostatitis
Interstitial cystitis

Both Sexes

Pelvic floor dysfunction
Irritable bowel syndrome
Nerve entrapment
Musculoskeletal causes
Sometimes no clear cause found

Diagnosis

Detailed history
Physical examination
Pelvic ultrasound
Laparoscopy (if indicated)
Often multidisciplinary evaluation

Treatment³

Multidisciplinary Approach

Gynecology or urology
Physical therapy
Pain management
Psychology

Physical Therapy

Pelvic floor therapy
Manual therapy
Relaxation training

Medications

Pain medications
Hormonal treatments (for women)
Antidepressants
Anticonvulsants

Other Options

Nerve blocks
Trigger point injections
Surgery (for specific causes)

References

Engeler D, Baranowski AP, Borovicka J, et al. EAU guidelines on chronic pelvic pain. Eur Urol. 2020.
Till SR, As-Sanie S, Schrepf A. Psychology of chronic pelvic pain: prevalence, neurobiological vulnerabilities, and treatment. Clin Obstet Gynecol. 2019;62(1):22-36.
Speer LM, Mushkbar S, Erbele T. Chronic pelvic pain in women. Am Fam Physician. 2016;93(5):380-387.