Pelvic Pain Syndrome
Chronic discomfort or pain in the pelvis is commonly only recognised in men, but is frequently seen and often misdiagnosed in women. Now commonly known as CPPS/CP – Chronic Pelvic Pain Syndrome/Chronic Prostatitis
Pelvic floor disorders involve a dropping down (prolapse) of the bladder, rectum, or uterus caused by weakness of or injury to the ligaments, connective tissue, and muscles of the pelvis.
The vestibule is where the vulva (area of the skin on the outside) meets with the vagina. It is an extremely sensitive part of your body and contains the Bartholin’s gland (which produces vaginal lubrication), the urethra (where you pass urine) and a number of the small minor vestibule glands which also produce vaginal discharge.
Vestibulitis was the former term for vestibulodynia. This term is out of date now. It is slightly misleading as it implies that the vestibule is inflamed – hence the term vestibulitis. It is not believed that an inflammatory process in the skin is to blame for symptoms. An excessive sensitivity of the nerve fibres and even, on occasions, overgrowth of the nerve fibres in the area is believed to be responsible for symptoms.
Vaginismus is a continuous prolonged spasm of the pelvic floor muscles that contract in orgasm. A continuous spasm of these muscles can lead to severe pain and make penetration or intercourse impossible. Vaginismus may be a result of various conditions that cause vulvar pain or irritation. It can also be a result of the anticipation of pain or a recollection of a negative sexual experience.
Vulvodynia refers to a disorder of vulvar pain, burning, and discomfort that interferes with the quality of life. No discernible physical lesion other than perhaps some redness of the vestibule is present. The cause can sometimes be attributed to trauma, but in many other cases its origin is unknown.
Pelvic pain is also very common in men. In fact, a recent study from Standford University found that the majority of men diagnosed with prostatitis in fact had pelvic pain syndrome.
We are particularly interested in helping people with pelvic pain. There are many different types of pelvic pain (interstitial cystitis alone has seven categories in TCM), os individualised treatment is important. We have a health model based around the concept of Mind-Metabolism-Myofascia-Meaning, so everybody with a complex syndrome such as pelvic pain will have a programme incorporating support on all four of those levels.
Read more about our approach to treatment:
- Stefan Chmelik outlines which treatments may be most effective for pelvic pain
- Dr Brian Kaplan discusses homeopathy for pelvic pain
Chronic Pelvic Pain Syndrome comes in many guises, and people may have any of the following diagnoses:
- Interstitial cystitis (IC)
- Pelvic Floor Dysfunction (PFD)
- Vestibulitis, vulvodynia, clitorodynia, vaginismus, prostatodynia
- Non-bacterial cystitis or prostatitis
- Reproductive pelvic pain
- Dyspareunia
- Bladder pain syndrome/interstitial cystitis (BPS/IC)
- Overactive Bladder Syndrome (OBS)
- Irritable Pelvis Syndrome (IPS)
- Urgency-Frequency Syndrome (UFS)
- Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS )
- Prostate Pain Syndrome (PPS)
- Painful Bladder Syndrome (PBS)
- Endometriosis Associated Pain Syndrome
- Urethral Pain Syndrome
- Penile Pain Syndrome
- Scrotal Pain Syndrome
- Vaginal Pain Syndrome
- Vulvar Pain Syndrome
- Pudendal Pain Syndrome
- Vestibular Pain Syndrome
- Clitoral Pain Syndrome
- Epididymal Pain Syndrome
- Post-vastectomy Pain Syndrome
- Perpetual Arousal Syndrome (PAS)
Sources
- Anderson, Wise et al, Treatment Protocol for Refractory Chronic Prostatitis/Chronic Pelvic Pain Syndrome Using Myofascial Release and Paradoxical Relaxation Training, The Journal of Urology, DOI: 10.1016/j.juro.2010.11.076
