Is your pelvic pain all in your head?

Chronic prostatitis and chronic pelvic pain syndrome (CPPS) can affect men of any age. This difficult-to-treat condition involves pelvic pain that may come and go for at least three months, and it can also lead to other problems such as pain during sex, urinary symptoms and feeling as though you are sitting on a golf ball. But the origins of this pain may well be all in your head.

Having your pain originate from your head does not mean that your pain is not real. Experts know that CPPS pain can stem from many causes in the body that do not originate in the prostate itself. One of the most common contributors is a man’s psychological health, as the mind-body connection is very powerful. Stress and prostatitis are closely related, as are prostatitis and anxiety, depression and other psychological issues.

How can your stress and emotions affect your pelvic health? They seem so unrelated, but stress and anxiety can attack your health in several ways. First there is the musculature. Some men carry their stress in their neck, back or shoulders, leading to chronic headaches and neck pain over time. Other men unknowingly tense their pelvic muscles when stressed. Over time, this causes inflammation that can lead to weaknesses or chronic tension and trigger points in the pelvic floor muscles, causing pelvic pain and other problems in the area.

Stress also affects health on a hormonal level. Stress, anxiety, and other emotional problems can elevate a person’s prolactin levels. This damages the immune systems and may result in inflammation and a possible imbalance in the neuroendocrine system. The result can be chronic pain.

Several studies have found that men who have high levels of stress and little emotional and social support are associated with a history of having prostatitis. What’s worse is that the more stress you are under the more likely you are to be in pain. So getting stressed out and frustrated with your chronic condition can actually make it worse for you. It’s a vicious cycle.

A study on men with CPPS in Taiwan found a relationship between anxiety and prostatitis. When researchers reviewed men’s health records, they found that men with CPPS are twice as likely to have a previous diagnosis with an anxiety disorder.

How to treat stress and anxiety

If you have a pelvic floor disorder that is causing your pelvic pain, there are a lot of alternative treatments for prostatitis available to you. The best way to manage pelvic pain that is related to stress or your emotions is through stress management techniques for treating prostatitis. Managing your stress and anxiety can help you get to the source of your pain and treat more than just the symptoms. This is the key to long-term management.

There are many different ways to relieve stress. You have to experiment to find what works best for you. Some men find that exercise works well. Whether going for a run, hitting the weights, or doing more calming exercises like yoga clears your head, exercise has tremendous value in reducing stress. It is also worth trying meditation and breathing exercises, especially if you are prone to anxiety.

There is a reason many of the programs for treating pelvic pain combine both the treatment of the muscles with psychological components. Whole-body approaches to prostatitis like my NPAT Treatment Program look at pelvic pain as a whole-body problem.

My holistic approach involves natural treatments like diet, phytotherapy, alternative treatments (like prostate massage, acupuncture and pelvic rehabilitation), and total body approaches (like stress management, exercise and lifestyle). Treating the whole body from the head to the prostate and beyond with a multimodal treatment plan is going to address any possible causes of your pelvic pain.

The XY Health Program by Isa Herrera is another whole-body approach that provides exercises, stretches, and pain-relief methods, and it addresses the mind-body connection. This physiotherapy is for pelvic floor dysfunction and trains the patient to achieve relief from his pelvic pain using his muscles and his mind.

Other prostatitis treatment programs incorporate treating the pelvic floor muscles and the brain because they recognize that psychological component and mind-body connection is an important piece to address in healing. The Wise-Anderson treatment involves methods for treating the pelvic muscles along with a program of psychological therapy to treat the behaviors that cause the tension in the first place.

It is important to keep in mind that treating male pelvic pain takes time and patience. Quick fixes like antibiotics do not work because CPPS is not caused by bacteria, and taking antibiotics when they are not necessary can actually harm your health. Look for natural, drug-free therapies that treat the possible cause(s) of your problems. The great part of natural and alternative therapies for stress and pelvic pain is that they do not have negative side effects, and many of them can be done in your home. Another part you may appreciate is that these treatments provide benefits for your whole-body health as well.


Dr. Geo Espinosa

By Dr. Geo Espinosa

Dr. Geo Espinosa is a naturopathic doctor, licensed acupuncturist and certified functional medicine practitioner recognized as an authority in holistic urology and men’s health. He is Clinical Assistant Professor and holistic clinician in Urology at New York University Langone Medical Center. As an avid researcher and writer, Dr. Geo has authored numerous scientific papers and books including co-editing the Integrative Sexual Health book, and author of the best selling prostate cancer book: Thrive, Don't Only Survive.