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Chronic Prostatitis and Chronic Pelvic Pain Syndrome: Causes & What You Can Do

Katelyn Hagerty FNP

Medically reviewed by Kristin Hall, FNP

Written by Our Editorial Team

Last updated 7/19/2021

Cramping, throbbing, aching down below—sounds terrible, eh? Chronic pelvic pain, also known as chronic prostatitis, is no fun to deal with. 

It’s a condition that most commonly affects men over the age of 50, though younger men can be diagnosed with it as well. 

We won’t sugar coat it: This kind of prostatitis can be tricky to figure out and sometimes difficult to manage. It can cause quite a bit of discomfort in the pelvic region.

Here’s how to tell if you might be experiencing chronic prostatitis symptoms, potential medical therapy to treat them and more. 

The Prostate: Explained

The prostate is part of the male reproductive system. It’s a small walnut-shaped gland nestled under the bladder and behind the rectum. It surrounds the neck of the urethra. 

The urethra is the tube that carries urine from the bladder outside of the body. It also carries semen out of the penis.

The main function of the prostate gland is to create the fluid that goes into semen.

What Is Prostatitis?

Prostatitis is categorized as an inflammation of the prostate gland and is a fairly common condition. In fact, it’s the most common urinary tract issue for men under the age of 50 and the third most common for men over the age of 50.

There are four forms of prostatitis you should know about. They are:

  • Chronic prostatitis/chronic pelvic pain syndrome (CP/CPP): This is the most common type of prostatitis and may present as pain in the lower back and pelvic area caused by a non-bacterial infection.

  • Chronic bacterial prostatitis: The chronic bacterial infection is rare and requires a prostate fluid culture to verify. 

  • Acute (or sudden) bacterial prostatitis: Also uncommon, this bacterial infection comes (and goes!) quickly.

  • Asymptomatic inflammatory prostatitis: Inflammation is present, but symptoms are nonexistent for this type of prostatitis. It’s usually discovered while you’re being checked for something else. This type doesn’t require treatment.

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Causes of Chronic Prostatitis

Unfortunately, what causes chronic prostatitis is not completely known. 

It’s believed that a microorganism (not bacteria) may cause the condition. 

Chronic prostatitis may also be connected to chemicals in urine and your immune system’s response to a previous urinary tract infection (UTI) or nerve damage to the area. 

Experts believe that local infections, chemical irritations, neuromuscular disturbances or an immunological response may all be leading causes for the condition.

Chronic Prostatitis Symptoms

The main identifier or chronic prostatitis is pain or discomfort lasting more than three months in one more of the following areas:

  • Lower abdomen (toward the center)

  • Penis

  • Scrotum

  • Lower back

  • The area between the scrotum and anus

Other common symptoms of prostatitis include:

  • Pain with ejaculation

  • Pain during or after urination

  • Urinating eight or more times a day

  • A weak or interrupted urine stream

  • The inability to delay urination (you can’t “hold it”)

Diagnosing Chronic Prostatitis

Only a healthcare provider can diagnose chronic prostatitis. To do so, your provider will likely consider your personal and family medical history, conduct a physical exam and perform some medical tests.

During the physical exam, a healthcare professional may check for discharge from the urethra, enlarged lymph nodes in the groin and a tender or swollen scrotum. 

You may also need a rectal exam performed to check and see if the prostate is enlarged.

Common medical tests used to diagnose chronic prostatitis include urinalysis, semen analysis, blood tests and a transrectal ultrasound.

Chronic Prostatitis and Erectile Dysfunction

When you’re experiencing discomfort down south, it can be hard to think about sex. In fact, the pain can lead to erectile dysfunction (ED).

One 2016 study looked at 1,406 men with chronic prostatitis. Of these men, 45.6% experienced mild ED, 46.6% dealt with moderate ED and 7.7% had severe ED.

The best way to diagnose sexual dysfunction associated with chronic pelvic pain syndrome is to talk to a healthcare professional. 

Sometimes, men who suffer from ED discover they’re  dealing with chronic prostatitis through the diagnosis process. 

If it’s determined that you’re experiencing  ED as a result of chronic prostatitis,  treating the prostatitis will be your first step. Your healthcare provider may also prescribe an ED medication like sildenafil or tadalafil to help manage your symptoms. 

Available Treatment Options

When treating chronic prostatitis, the goal is to reduce the symptoms and, therefore, the discomfort.

Medications commonly prescribed to treat chronic prostatitis include silodo, 5-alpha reductase inhibitors like finasteride (which Hims also offers for hair loss), muscle relaxants and neuromodulators.

Prescription medications aren’t the only way to go, though. A healthcare provider may also recommend heating pads or regularly taking a warm bath to treat discomfort. 

Kegel exercises may also help strengthen pelvic muscles, which can help with chronic prostatitis.  This involves tightening and releasing the muscles you’d use if you wanted to stop urine mid-stream. 

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There Is Hope for Sufferers of Chronic Prostatitis

As you can see, dealing with this chronic condition can be frustrating and, at times, painful. 

But the good news is, there is a way to deal with it. The first step you need to take? Reaching out to a healthcare provider who can assess what may be going on to help determine if you might be experiencing chronic prostatitis or chronic pelvic pain syndrome.  

From there, you’ll be able to discuss medication options, along with other ways you can manage and heal your discomfort and pain.

6 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

  1. Unlocking the mystery of chronic pelvic pain syndrome. Harvard Health Publishing. Retrieved from https://www.health.harvard.edu/mens-health/unlocking-the-mystery-of-chronic-pelvic-pain-syndrome
  2. Prostatitis: Inflammation of the Prostate. National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved from https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/prostatitis-inflammation-prostate
  3. What are Prostatitis and Related Chronic Pelvic Pain Conditions? Urology Care Foundation. Retrieved from https://www.urologyhealth.org/urology-a-z/p/prostatitis-(infection-of-the-prostate)
  4. Vaidyanathan, R., Mishra, V., (2008, Jan-Mar). Chronic prostatitis: Current concepts. Indian Journal of Urology, 24(1): 22-27. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684227/
  5. Sex and the Prostate: Overcoming erectile dysfunction when you have prostate disease. Harvard Health Publishing. Retrieved from https://www.health.harvard.edu/blog/sex-and-the-prostate-overcoming-erectile-dysfunction-when-you-have-prostate-disease-20090331100
  6. Zhang, Y., Zheng, T., Tu, X., et al. (2016). Erectile Dysfunction in Chronic Prostatitis/Chronic Pelvic Pain Syndrome: Outcomes from a Multi-Center Study and Risk Factor Analysis in a Single Center. PLOS ONE, 11(4). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4847827/

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

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