Chronic Pelvic Pain
Understanding Chronic Pelvic Pain
Dr. Mohamed Otify, a Consultant Gynaecologist and Gynaecological Surgeon, specialises in investigating and treating chronic pelvic pain through advanced diagnostic and minimally invasive approaches, including laparoscopy and robotic surgery.
Chronic pelvic pain refers to pain below the belly button that lasts six months or more. It can be caused by various conditions, including fibroids, endometriosis, or gynaecological cancer, or sometimes no single identifiable cause is found. The goal of treatment is always the same: to relieve pain, improve comfort, and help you regain control over your daily life.
Symptoms
Chronic pelvic pain can vary widely from person to person. It may be:
- A dull, constant ache or a sharp, stabbing sensation
- Intermittent or steady
- Localised or widespread across the lower abdomen
You may also experience:
- Pain during intercourse
- Pain when urinating or opening your bowels
- Discomfort after long periods of standing or sitting
The pain may range from mild to severe, sometimes disrupting sleep, exercise, or work.
When to Seek Medical Advice
You should see a doctor if:
- Your pelvic pain is interfering with your quality of life
- The pain has lasted more than a few months
- Your symptoms are worsening
Chronic pelvic pain is treatable — identifying its cause is the first step.
Common Causes
Chronic pelvic pain can arise from several overlapping factors. In many cases, more than one condition contributes to symptoms. These may include:
1. Endometriosis: When tissue similar to the uterine lining grows outside the womb, causing inflammation, scarring, and cysts that lead to cyclical or constant pain.
2. Musculoskeletal Problems: Pelvic floor tension, fibromyalgia, hernias, or joint inflammation can all contribute to persistent pelvic discomfort.
3. Chronic Pelvic Inflammatory Disease (PID): Long-term infection may cause scarring of the fallopian tubes and surrounding tissues.
4. Ovarian Remnant or Fibroids: Residual ovarian tissue or fibroid growths can create pressure and pelvic heaviness.
5. Bladder and Bowel Conditions: Irritable bowel syndrome (IBS) or interstitial cystitis (painful bladder syndrome) can mimic gynaecological pain.
6. Pelvic Congestion Syndrome: Varicose veins in the pelvis may contribute to a dull, aching sensation.
7. Psychological and Emotional Factors: Stress, anxiety, or past trauma can amplify pain perception and make symptoms harder to manage. A holistic approach — addressing both body and mind — is often most effective.
Diagnosis
Finding the cause often involves several steps:
- Pelvic examination to check for tenderness or masses
- Ultrasound scan of uterus and ovaries
- Blood and infection tests
- MRI or CT imaging for complex cases
- Diagnostic laparoscopy to look directly inside the pelvis for endometriosis or scarring
Sometimes, no single cause is found — but treatment can still significantly reduce symptoms.
Your Appointment
During your consultation, Dr. Otify will discuss your symptoms in detail, review your medical history, and may recommend further imaging or a laparoscopy if appropriate. Together, you will create a personalised management plan focused on long-term relief and improved quality of life.
Treatment Goals
Even when pain can’t be completely eliminated, it can usually be controlled and managed effectively. Treatment may include:
- Medication to ease inflammation or pain
- Hormonal therapy where endometriosis is suspected
- Minimally invasive or robotic surgery to remove adhesions or endometriosis deposits
- Pelvic floor physiotherapy
- Psychological support and pain management programmes
With careful diagnosis and multidisciplinary care, many women find lasting relief and regain confidence in their wellbeing. If chronic pelvic pain is affecting your daily life, consider an online consultation with Dr. Mohamed Otify to explore your treatment options and start your journey toward comfort and recovery.
