Chronic Pelvic Pain What is Chronic Pelvic Pain (CPP)?

Pelvic PainThis is defined as continuous or episodic pain located below the umbilicus, lasting 6 months in duration, and of sufficient severity to cause interference with daily activities and/or requiring medical or surgical intervention. It has been reported that up to 40% of women ages 18 to 50 suffer with this condition.

What causes CPP?
There are a large number of diagnoses that can cause CPP.  Many of them are related to specific organ systems.  Some examples include but are not limited to…

  • Gastrointestinal – Irritable Bowel Syndrome,
  • Colitis, Diverticular Disease, Cancer
  • Gynecologic – Ovarian cysts, Fibroids,
  • Endometriosis, Vaginal Atrophy
  • Urologic – Interstitial Cystitis, Urinary Tract
  • Infection, Bladder Prolapse
  • Musculoskeletal – Spinal Problems,
  • Muscle Spasm, Vaginal Trigger Points

 

How does my doctor identify the cause?
As noted above some causes can be very serious so this complaint should always be evaluated. A good place to start is with your primary care physician so they can direct you to the appropriate specialists if needed. Evaluation includes a thorough history and physical (including a pelvic exam). It may also include blood work, urinalysis and an imaging study such as a CT Scan or Pelvic Ultrasound.

What can I do about CPP?
Treatment depends on the cause that your doctor identifies but it is worth noting that CPP may be caused by a chronic vaginal muscle spasm (trigger point). These trigger points may exist in the pelvic muscles near the vagina. If this is the case it can cause severe pelvic pain and significant pain during intercourse. It is more common than initially thought and can be identified as a palpable painful area of muscle on vaginal exam.

Once identified, transvaginal injections of pain medication, a steroid and even Botox can alleviate this pain and restore normal pelvic function.  In a study I did at the Cleveland Clinic Florida we were able to alleviate this cause of pain in 72% of women studied for a period of 6 months. This was life changing for some of these women and allowed them to have normal sexual function again. This has recently been brought to the attention of American women who read the article “Botox Saved my Sex Life” in the September 2011 issue of Marie Claire.

Dr. Carolyn F. Langford is a cum laude graduate of Rutgers University and graduate of the University of Medicine and Dentistry of New Jersey School of Osteopathic Medicine.

She is one of a few doctors, in Southwest Florida, offering Botolinum Toxin for overactive bladder as well as neurmodulation. She is a clinical instructor for other physicians by Boston Scientific and a speaker for Warner-Chilcott. Dr. Langford also treats pelivc floor pain disorders including female sexual dysfunction.

Dr. Langford is board certified by the American College of Osteopathic Surgeons. She is also a Fellow of the American College of Osteopathic Surgeons.

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