Chronic Pelvic Pain ~ Gynaecology
Channel: About Medicine
Date: 2018-09-01

In this video, I aim to explore the experience and cultural background of persistent pelvic pain in women. 

Bear in mind that this condition can also impact men, but that's not the focus of this video.


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Resources

Pelvic Pain Report: https://www.pelvicpain.org.au/pelvic-pain-report/

http://www.pelvicpain.org.au/

http://www.pelvicpain.org.au/wp-content/uploads/Easy-Stretches-to-Relax-the-Pelvis-F-1.pdf

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References

https://www.racgp.org.au/afp/2015/july/management-of-persistent-pelvic-pain-in-girls-and-women

https://www.ncbi.nlm.nih.gov/pubmed/19830953

https://www.ncbi.nlm.nih.gov/pubmed/15704703


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Some studies suggest that around a quarter of women experience, or have experienced, persistent pelvic pain. In this video were going to look further into that condition, to understand one tiny bit more of what those people - what may be one eighth of the entire world - are going through.



The pain experience is complicated by the nature of its location. It is bound up with questions of  fertility, of sexual dysfunction.

The person with it may be disabled by pain, but may find it hard to be honest about, even with friends, and family, much less health professionals.

Without the ability to communicate and share, people can become isolated in their pain experience, increasing their distress, which goes on to worsen the pain.

As with all forms of chronic pain, we can think about PPP in terms of four qualities:

1. The intrinsic organ-derived pain
2. The response from our muscles to this pain
3. Nerve pathway central sensitisation
4. The ongoing psychosocial impacts

That last category extends into the sex lives of people with PPP, and from that, intimate relationships in general. An adolescent with PPP may not feel comfortable to get in to a relationship, for fear of what may result.

So yes, it’s hard. But that doesn’t mean it can’t get better.

A range of treatment options exist, beyond the scope of this video. Some lie in the hands of the patient, some in the hands of the treating team.

Importantly, the earlier the problem is picked up, the better the person’s outcomes will be. It’s critical to step in before the negative spiral picks up strength. [Diagnosis and intervention] Sadly, one of the main complaints you’ll hear from people with the condition is that they’ve faced interminable delays in the recognition and diagnosis of their condition. So in order for us to catch it early, some change needs to happen.

Current recommendations include better education on the topic, across the board - through medical schools, doctor training programmes, as well as through the community. Better research, better guidelines for treatment, and less stigma.

To quote the Pelvic Pain Report, which was written in 2011 by a group of determined doctors and community advocates, this condition has copped considerable ‘stigmatisation and neglect, with resulting disastrous effects on women and young girls’. I’d recommend reading the report, and I’ve put a link in the description below.

Thanks for watching, and we’ll see you next time.