Not tonight Darling… I have a headache (in the pelvis!)

Pelvic pain, like headaches, can have a significant impact on a patient’s sexual functioning, relationship and quality of life.  The common perception is that a headache is the cliché excuse for avoiding intercourse.  But what if the ache is real, only it’s in the pelvis? Is pelvic pain only in the patient’s head? We look at conditions that cause chronic pelvic pain and other pains that are triggered by sexual intercourse: Chronic pelvic pain conditions are often associated with other pain conditions and are especially common in patients who have had repeated pelvic surgery.  Specific conditions such as Pudendal Neuralgia and Painful Bladder Syndrome are relatively easy to identify and treat, often in the context of a multidisciplinary team. Sexually provoked pain (dyspareunia) can be superficial or deep.  Deep Dyspareunia is often due to an organic cause such as ovarian, uterine or bowel abnormalities.  Superficial Dyspareunia is usually a neuropathic pain associated with induced neuroproliferation and/or a hypertonic pelvic floor. The aim is to provide practical tools to identify and treat patients with this very frustrating complaint, and hopefully to contribute to increased satisfaction for the doctor, patient and partner.