What Links Prostatitis and Female Pelvic Pain?

One common link between prostatitis and female pelvic pain is that both are often misdiagnosed, inadequately treated, and can linger for months or years. Another connection they share is the mistaken belief that these conditions are caused by infections and consequently are treated ineffectively with antibiotics. For example, prostatitis is often treated with antibiotics even though that treatment seems to be highly effective in only about 5% of cases. When it comes to the prostate I can speak from personal experience. In the mid-1970’s I was diagnosed with prostatitis and treated with antibiotics. That treatment not only didn’t relieve the unpleasant symptoms attributed to what was called ‘prostatitis’ but actually generated new discomfort … that I endured for the next decade. The good news was that that very unpleasant ordeal forced me to look for answers beyond mainstream, pharmaceutical-based medicine. The end result was a healthier prostate and an unplanned change in career direction.  

What’s Really Going On?

Prostatitis and interstitial cystitis, a common painful pelvic condition in women, often share an underlying cause. Treatment strategies based on relieving excessive muscle tension on the floor of the pelvis have proven effective in relieving pain in both of the ailments mentioned above, and in a number of other pelvic complaints. These conditions are often referred to as Chronic Pelvic Pain Syndromes or CPPS. Chronic tension in the muscles that make up the floor of the pelvis can adversely influence the function of the glands and organs that reside in the pelvis. It’s believed that stress-induced trigger points in these muscles can impair circulation and even cause inflammation in these glands and organs that leads to various forms of dysfunction and pain. When you hear about trigger points you often think about painful skeletal muscles in your neck, shoulders, or back. The muscles on the pelvic floor are just as vulnerable to stress-induced muscle tension and pain as any other muscle. One of the better books that I’ve read on this topic is by two Standford University doctors titled, A Headache in the Pelvis: A New Understanding and Treatment for Prostatitis and Chronic Pelvic Pain Syndromes. Just as with our more visible and easily palpable skeletal muscles, chronic muscle tension in the floor of the pelvis can produce an abundance of metabolic waste products, a deficiency of oxygen, and either local or referred pain and dysfunction.  

The Effective Treatment

The treatment protocol that I’ll describe is best utilized when other approaches have proven ineffective and when more serious pathologies have been ruled out. The treatment strategy outlined in A Headache in the Pelvis is two-fold. First trigger points in the pelvic muscles are treated, both internally and externally by a specially trained physical therapist. Another option is that individuals can learn to treat their own pelvic muscles at home with the assistance of a number of instruments designed specifically for that purpose. However it’s accomplished, the first part of the treatment is to address the pelvic floor muscles directly to reduce tension. The second aspect of the treatment is to retrain the brain and to balance the nervous system that’s responsible for the too tight muscles in the first place. Without this brain retraining, the tension will be more likely to return because the brain is programming the muscles to be tight. This brain and nervous system retraining is best accomplished by practices that involve becoming consciously aware of the body. Conscious awareness of muscle sensations, pain, and emotional experience are the keys to updating and reprogramming the brain and nervous system to support health and well-being. Experience has shown that a combination of these two approaches works best to consistently relieve the discomfort of CPPS. However, significant results have been achieved when the only intervention were the awareness practices without the direct treatment of the muscles. A study published in 1988 reported that 85% of men experienced significant relief from prostate symptoms by practicing awareness techniques only. On the other hand, treating the muscles only has shown to produce the less desirable outcome. In my experience, I’ve found that adding acupressure and acupuncture to the above protocols speeds up the reprogramming of the brain and nervous system. SomaSensing coaching is what I now call the collection of awareness practices that I teach.