What is Chronic Pelvic Pain Syndrome (CPPS)?

The cause of chronic pelvic pain in women and men may be hard to determine, so it’s important to work with a doctor as well as do at-home treatment.

chronic pelvic pain

Chronic pelvic pain in women and men may be recognized when urinating or while having sex.

© mi-viri | Getty Images

Chronic pelvic pain, or chronic pelvic pain syndrome (CPPS), is a pain in the pelvic area of men or women that lasts for six months or more. The pelvic area is the area below your belly and between your hips. The cause of CPPS may be hard to find and there are many options for treatment.

Chronic Pelvic Pain Syndrome in Women

According to the National Institutes of Health National Library of Medicine, chronic pelvic pain in women is a common condition that affects up to one in seven women. There are many possible causes of pelvic pain. If the pain lasts for three to six months, the brain becomes overly sensitive to pain and feels even mild pain as severe pain. This type of pain is called centralized pain and CPPS is a centralized pain syndrome.

CPPS in women may start with causes of pain that can include endometriosis, inflamed bladder, physical trauma, irritable bowel syndrome, pelvic inflammatory disease, sexual abuse, and many other causes. Depending on the cause, the pain may be described as sharp, dull, crampy, burning, or shooting. Pain may get worse when urinating, having a bowel movement, or having sex. It may also get worse during menstrual periods.

See more: Chronic Pelvic Pain Syndrome in Women

CPPS in women can be hard to diagnose because the cause of pain may be gone even though the feeling of pain continues. Mild pain caused by normal sensations like a menstrual period or sexual intercourse may trigger severe pain. Blood tests, urine tests, and imaging studies can be done to look for the cause of pain, but sometimes these tests are normal. In many cases, the diagnosis is made based on the history and the symptoms. Stress, depression, and anxiety commonly contribute to CPPS.

Treatment of CPPS may start with treating the cause of pain if it is found. For example, if a woman has endometriosis or pelvic inflammatory disease, treating these conditions may reduce CPPS symptoms. In many cases, other treatments may also be needed to control CPPS, and finding the right treatment may require a team of health care providers. For these reasons, CPPS is often treated best in a pain rehabilitation clinic or center.

Some of the more common treatments can include:

  • Over-the-counter pain relievers
  • Hormone treatments or birth control pills for pain related to menstrual periods
  • Antibiotics if an infection is suspected
  • Antidepressants
  • Physical therapy
  • Spinal cord stimulation
  • Pain control injections
  • Psychotherapy

Chronic Pelvic Pain in Men

Chronic pelvic pain in men is unexplained pain in the pelvic area with pain when passing urine and pain in the groin, penis, or the area between the scrotum and anus, called the perineum. There may also be strong and sudden urges to pass urine and pain after ejaculation. This condition is also called chronic nonbacterial prostatitis. Like CPPS in women, this condition is often associated with stress and anxiety.

Possible causes of pain include inflammation of the prostate gland caused by aging or prior infection. Other possible causes include low testosterone and undetected infections of the prostate gland. In the United States, this condition is most common in men over age 50.

Diagnosis of male CPPS includes a rectal exam of the prostate gland, urine testing, prostate fluid testing, and blood testing. Tests are often negative and the diagnosis is made by the history and symptoms. Treatment options include:

  • Antibiotics
  • Over-the-counter pain medications
  • Medications that improve prostate symptoms called alpha-adrenergic blockers
  • Physical therapy
  • Psychotherapy
  • Antidepressant medication

See more: Chronic Pelvic Pain Syndrome in Women

Chronic Pelvic Pain Syndrome Home Remedies

CPPS can have a negative effect on the quality of life and mental health. Finding ways to reduce stress and anxiety may help. Some recommended home remedies include:

  • Meditation
  • Deep breathing
  • Exercise
  • Avoiding constipation
  • Taking a warm bath

CPPS is a difficult condition to live with and it can take time to find the cause and the right treatment. Even if the cause is not found, which is not uncommon, working with a team of health care providers familiar with the condition frequently reduces symptoms and improves the quality of life.

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Chris Iliades, MD

Dr. Chris Iliades is board-certified in Ear, Nose and Throat and Head and Neck Surgery from the American Board of Otolaryngology and Head and Neck Surgery. He holds a medical … Read More

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