May has been designated Chronic Pelvic Pain (CPP) Awareness Month. CPP is a condition that is defined as ‘a non-menstrual pain in the pelvis that lasts up to six months or more and shows no improvement with treatment’.

It can be experienced by both men and women but is predominantly experienced by females. Interestingly, approximately 80%of women who experience CPP are found to have endometriosis. In women pelvic pain can originate from reproductive organs but in general other causes may be related to problems in the digestive, urinary, musculoskeletal or nervous systems.

Several organs may be contributing to the condition but there is no specific test to diagnose hence it is often misdiagnosed.

Depending on the place of origin, pelvic pain can be:

• dull or sharp,

• constant or intermittent,

• mild, moderate or severe. Body Signs & Symptoms It can present as:

• a generalised pelvic ache

• stabbing pains that interfere with movement

• pain that is aggravated by movement or prolonged positions • pain on intercourse

• period like cramping

• urinary urgency or an irritable bowel

• recurrent vaginal candidiasis

• sensitivity of the lower abdomen or it can painful to touch

• vulval pain.

Digestive conditions that can lead to CPP include:

• Irritable Bowel Syndrome (IBS)

• Diverticular Disease

• Coeliac Disease

• Peroneal Pain Syndrome

Gynaecological issues that can result in CPP include:

• Endometriosis

• Vulvar Pain Syndrome

• Vestibular Pain Syndrome

• Dysmenorrhea

Urinary system conditions that may cause CPP include:

• Chronic Pelvic Inflammatory Disease

• Prostate Pain Syndrome

• Bladder Pain Syndrome

• Residual Ovary Syndrome

• Postoperative Peritoneal Cysts

Musculoskeletal issues that may contribute include:

• Hip Osteoarthritis (OA)

• Piriformis Syndrome

• Fibromyalgia

• Sacroiliac Join (SIJ) Dysfunction

• Coccyx pain syndromes.

The regularity of CPP can impact quality of life as it interferes with daily activities including work, personal relationships and will often interrupt sleep. It can cause people to withdraw from social activities as well as experience anxiety, depression or low self-confidence.

Managing Chronic Pelvic Pain (CPP)

As there is no specific test it is beneficial to see a practitioner who understands that pelvic pain is real, and can be treated. An integrative health care approach has been found to achieve the best results and a pain management plan is an important component of treatment.

Naturopathy can be beneficial in the management off CPP and as an adjunct to medical intervention and by enhancing other natural therapy treatments.

A Naturopathic management plan focuses on:

Nutrition – this can be beneficial in modifying the diet and removing inflammatory foods and allergens from the diet.

Naturopathy – can address gastrointestinal tract integrity and support the gut microbiome which can be disturbed by stress and pain.

Natural supplements are also beneficial in modulating pain sensitivity. Lifestyle advice and patient education are paramount in helping people to understand how they can work to improve their quality of life.

Herbs – can help to reduce inflammation & pain and can also help to remove bacteria that may an underlying cause of inflammation. They are beneficial in supporting the nervous system and the reduction of the central stress response to pain.

Mindfulness & Yoga – research studies have found both these activities beneficial in coping with chronic pain.

— Marianne