Pelvic Pain Specialist

What is chronic pelvic pain (CPP)?

Chronic pelvic pain is complex, multifactorial syndrome with significant overlap between gynecologic, neurologic, gastrointestinal, urologic, musculoskeletal, and psychosocial contributors. Pain occurs in the area between the belly-button and mid-thigh and lasts 6+ months. Most patients have multiple pain generators and comorbid conditions and neuromuscular pain that is unfortunately often overlooked. 

What are predisposing factors of chronic pelvic pain?

Several factors contribute to the predisposition of CPP such as: cumulative pelvic or physiological traumas (i.e. sports, surgeries, history of abuse/trauma), comorbid conditions such as, endometriosis, IBS, fibromyalgia, TMJ, or interstitial cystitis, and about 20% of the population has a genetic predisposition for pelvic pain. 

In chronic pelvic pain our central nervous system becomes heightened causing the pain pathways to be hypersensitive to stimuli. This hyper responsiveness to pain needs to be turned down which is one of the goals of management.

How is CPP diagnosed? 

Diagnosis can be made through comprehensive history taking and examination. It is important to be thoroughly evaluated and to have time to discuss your history as well as your goals moving forward.

What management options are available?

Management of CPP is focused on improving both function and quality of life and often multimodal focusing on education, behavioral therapy, physical therapy, and pharmacology. 

At Markidan Gynecology, all management of chronic pelvic pain is highly individualized based on individualized symptoms and goals. We offer trigger injections for pelvic pain, pharmacologic options, and have an interdisciplinary team of referrals we can offer based on needs.