A Pelvic Pain Primer

What causes it, what to do about it

Pelvic pain can be worrisome. After all, it’s one of those nebulous conditions that “could be anything.” Pelvic pain affects both men and women, and its causes range from the innocuous to the very serious. If you experience pelvic pain, don’t panic, but don’t try to self-diagnose, either. Instead, visit your doctor, who will help you get to the root of the problem. But realize that pelvic pain “can be caused by stress, injury, or illness,” says Nurse Practitioner Rachele E. Khadjehturian of WESTMED Urology. “Previous trauma, including traumatic labor and/or birth, sexual assault, and abuse, can also lead to pelvic pain.”

According to Khadjehturian, “pain with sex [dyspareunia], burning urination [dysuria], discomfort of the vulva when wearing tight pants [vulvodynia] and pinching pain in the pelvis when sitting on a bicycle seat [possible pudendal nerve entrapment],” can happen at any age. In addition, says Khadjehturian, “urinary tract infections [UTIs] can cause dysuria; dryness can cause dyspareunia as well as dysuria, as can side-effects from medications. Back or pelvic injury can cause vulvodynia in women and scrotal discomfort in men.” Stress and anxiety, according to Khadjehturian, can cause any or all of the above issues, too, because people tend to “hold” stress in different parts of the body. “Some hold it in their neck and shoulders, manifesting in headaches, some in their pelvis, manifesting in pelvic pain.”

 In men, Chronic Pelvic Pain (CPP) can present itself in a number of ways, including scrotal pain, penile pain with erection or after ejaculation, and pain in the perineum when sitting on a bicycle.

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For CPP, Khadjehturian says it’s important to learn how to de-stress and relax. “Releasing the muscles of the pelvis and allowing spasms to dissipate will help the pain and discomfort of CPP, but it won’t happen overnight. Biofeedback training, pelvic yoga, and pelvic physical therapy are three of the least invasive ways to tackle the issues associated with CPP.” Medications, both oral and trigger-point injections, may also help. If these don’t do the trick, nerve blocks may be indicated.                                                  

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