By Grace De Morgan (Provisional Psychologist)
Chronic pelvic pain (CPP) is a condition that many Australian women and people assigned female at birth (AFAB) struggle with. Many feel alone and suffer in silence due to feelings of embarrassment and shame. So, let’s shake off the stigma and explore this very real, very common issue.
So, what Is Chronic Pelvic Pain (CPP)?
CPP refers to persistent pain in the lower abdomen, pelvis, genitals, lower back and even upper thighs that generally:
· Lasts longer than six months
· Does not respond to initial treatments
· And impacts your daily function.
In Australia, it is estimated that pelvic pain impacts up to one in five women and AFAB, and one in 12 men and AMAB. According to the Australian Bureau of Statistics, those with a condition like endometriosis may have to wait an average of 6-8 years before diagnosis.
For some, the pain they experience is constant, while for others, it comes and goes. The pain may flare up around periods, during or after sex, when sitting, exercising, urinating, eating, or can sometimes occur without any obvious triggers. It can lead to fatigue, anxiety, and low mood.
Conditions that may underlie or contribute to CPP include:
Endometriosis
Adenomyosis
Pelvic inflammatory disease
Vulvodynia
Bladder pain syndrome / interstitial cystitis
Irritable bowel syndrome (IBS)
Pelvic floor dysfunction
Past surgical trauma or scar tissue.
CPP can be experienced by anyone, regardless of age, race, ethnicity, or social and economic background. That being said, it is more commonly experienced by populations of veteran women, those with a history of sexual trauma, post-traumatic stress disorder (PTSD), anxiety, depression, those with a history of smoking or substance abuse, and those who have had multiple surgeries.
More than a gynaecological issue
What many people don’t realise is that chronic pelvic pain is not solely a biological issue; it’s also a psychological and sociological one. However, this doesn’t mean that the pain is “all in your head”.
The fact is, the way we experience and cope with pain is shaped by many factors, including our nervous system, our stress responses, our coping behaviours, our thoughts, our past experiences, and our current support networks. Understanding and working with these influences is where a psychologist can be particularly helpful in reducing the impact of your pelvic pain.
How a psychologist may help
While seeing a psychologist won’t necessarily cure pelvic pain, they may be able to provide you with a clearer framework to manage it. This may include:
Chronic pain psychoeducation: Helping you to better understand how chronic pain works in the brain and how our nervous systems can become overly sensitised to pain signals.
Anxiety management: Using strategies from Cognitive Behavioural Therapy (CBT) and/or ACT (Acceptance and Commitment Therapy), a psychologist could support you to manage unhelpful thoughts, fear-avoidance, and improve your ability to cope with pain.
Regulation strategies: Using mindfulness and grounding strategies, you can learn how to soothe your body’s stress responses (which often amplify pain signals when focused upon).
Support for trauma: If pelvic pain is triggered or worsened by medical procedures and/or sexual experiences, addressing previous trauma can help ease pain in these situations.
Pacing and lifestyle management: By reviewing your diet and exercise and scheduling daily activities in a sustainable manner, your pain flare-ups can be better managed, and your sense of control regained.
Multidisciplinary support may be necessary
While seeing a psychologist can provide valuable support, managing chronic pelvic pain often requires a team-based approach, including a:
GP or gynaecologist
Pelvic physiotherapist or pain specialist
Clinical psychologist
Dietitian (especially if gut health is involved).
Please know that if you don’t feel heard by your current healthcare team, it is more than OK to seek out a second opinion.
Your pain is real, and you deserve the best support available to you.
Accessing Support at HMC
If you would like to explore whether Healthy Mind Centre may be the right service for you, please email us at admin@healthymindcentre.com.au to start the triaging process.
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