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This discussion is aimed principally at men who experience pelvic pain, often diagnosed as prostatitis or as chronic pelvic pain syndrome. The urologist I saw at the onset of the complaint explained that it is hard to treat because there may be several causes. Once bacterial prostatits has been ruled out (apparently that is the easy part!) urologists are left with few proven methods of treatment.
The symptoms are severe continuous pain in the groin, and/or penis, worsened by sitting and by any kind of stretching of the groin area.
I was treated by a daily dose of tamsulosin, intended to relax the muscles of the pelvic floor. In my case it had little effect.
What has helped to reduce the pain almost to zero has been a low dose of amitryptiline. Amitryptiline was first introduced as an anti-depressant at high doses like 150mg. At some stage it was discovered that it eased pelvic pain but in very low doses. My GP had attended a conference and spoken to urologists who advised him to prescribe this drug.
You start at the low dose of 10mg once a day and give yourself time to adjust to any sleepiness effects it has on you. I found that by taking it at about 8pm and after getting used to it, there were no unwanted effects the following morning. For me the level of dose which has worked best is 20mg each evening.
Now I can sit on any chair and carry out activities which pain prevented before.
I no longer need tramadol or indeed any other pain killers. In any event, I discovered that most hardly work for pelvic pain. Amitryptiline, I am told, affects seratonin production in the brain and suppresses pain triggers from the pelvic area.
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