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Chronic Pelvic Pain in Fibromyalgia & Chronic Fatigue Syndrome

They Often Go Together

By

Updated June 30, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Chronic pelvic pain is common in people with fibromyalgia (FMS) and chronic fatigue syndrome (ME/CFS). However, it's important to know that it's not a symptom — it's an overlapping condition that should be diagnosed and treated separately.

Chronic pelvic pain is actually an umbrella term for any condition that causes persistent pain in and around the pelvic cavity. To be considered chronic, it must continue for at least six months.

The Basics of Chronic Pelvic Pain

A lot of conditions can cause chronic pelvic pain. Research links only some of them to FMS and ME/CFS (denoted with a * below), but your doctor may want to explore some of the others depending on your specific symptoms.

Some conditions that can cause chronic pelvic pain are gender-specific. Causes specific to women include:

  • *Vulvodynia
  • *Dysmenorrhea (painful period)
  • Endometriosis
  • Uterine fibroid tumors
  • Pelvic joint instability linked to childbirth

Some common causes specific to men are:

  • Chronic prostatitis (inflammation of the prostate)
  • Penile or testicular pain syndromes
  • Post-vasectomy pain syndrome

Causes that are not necessarily related to gender include:

Symptoms, treatments and diagnostic procedures vary based on the specific condition. The sheer number of possible causes can complicate diagnosis, so it may take a considerable amount of time to find out exactly what is causing your pain.

Why is Chronic Pelvic Pain Linked to FMS & ME/CFS?

While we don't fully understand the relationships between these conditions, some researchers now believe FMS, ME/CFS and chronic pelvic pain are all in a "family" of illnesses called central sensitivity syndromes (CSS).

All CSS involve an underlying mechanism called central sensitization, which involves heightened pain response and extreme reactions to different types of stimuli.

Chronic Pelvic Pain in FMS & ME/CFS

Chronic pelvic pain, like any pain source, may cause symptoms of FMS or ME/CFS to intensify. Proper diagnosis and treatment of overlapping conditions is an important part of quieting all your symptoms.

Because some symptoms are common to multiple CSS, you may get double duty out of some treatments, such as pain medication (NSAIDs, opiates) and SSRI/SNRI antidepressants.

If you believe you have chronic pelvic pain, talk to your doctor to get the diagnostic process started.

Sources:

Mayer TG, et al. Pain practice. 2012 Apr;12(4):276-85. The development and psychometric validation of the central sensitization inventory.

The Merck Manuals Online Medical Library. Pelvic Pain. Accessed January 2013. Pelvic Pain

Rodriguez MA, et al. Journal of urology. Jan;189(1 Suppl):S66-74. Evidence for overlap between urological and nonurological unexplained clinical conditions.

Rodriguez MA, et al. Journal of urology. 2009 Nov;182(5):2123-31. Evidence for overlap between urological and nonurological unexplained clinical conditions.

Smith HS, Harris R, Clauw D. Pain physician. 2011 Mar-Apr;14(2):E217-45. Fibromyalgia: an afferent processing disorder leading to a complex pain generalized syndrome.

U.S. Departmen of Health & Human Services. National Guideline Clearinghouse. Chronic Pelvic Pain. Accessed January 2013.

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