Chronic Pelvic Pain—Female
Condition
(Pelvic Pain, Chronic)
Definition
Pelvic pain occurs between the belly button and the hips and groin. It is chronic when it lasts for six months or more.
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Many things can cause pelvic pain, such as:
- Problems of sexual organs or related conditions, such as:
- Endometriosis
- Pelvic inflammatory disease
- Fibroids
- Pain when ovulating
- Menstrual pain
- Adenomyosis
- Cysts
- Pelvic congestion syndrome
- Problems with the intestines such as:
- Diverticulitis
- Irritable bowel syndrome
- Constipation
- Inflammatory bowel disease
- Cancer
- Ulcerative colitis
- Urinary problems, such as:
- Injuries to the muscles, nerves, hips, or back
In others, the cause is not known.
Risk Factors
Things that may raise the risk of this problem are:
- Heavy menstrual flow
- Miscarriage
- Cesarean section or pelvic surgery
- Alcohol or substance use disorder
Symptoms
Pain can vary from person to person. A person may have:
- Constant pain or a dull ache
- Burning, shooting pain
- An urgent need to pass stool
- Pain that comes and goes
- Pain that ranges from mild to severe
- Pain with certain activities
- Pain with lengthy sitting
Diagnosis
The doctor will ask about your symptoms and health history. You will also be asked about the pain. A physical exam may be done.
These tests may be done to look for a cause:
- Blood tests
- Urine tests
- Images, such as x-rays and ultrasound
- Minimally invasive surgeries—to view or test tissue
Treatment
Underlying causes will be treated.
The goal of treatment is to manage pain. Choices are:
- Medicines, to ease pain, such as:
- Over the counter or prescription pain relievers
- Hormone therapy for pain related to the reproductive system
- Antidepressants or anti-seizure medicines
- Alternative therapies, such as acupuncture
- Mental health counseling to learn to manage unhealthy thought patterns that make it harder to cope with pain
Prevention
Prevention will depend on the cause. Some causes cannot be prevented.
The American Congress of Obstetricians and Gynecologists
The International Pelvic Pain Society
CANADIAN RESOURCES:
Health Canada
The Society of Obstetricians and Gynecologists of Canada
The American Congress of Obstetricians and Gynecologists
The International Pelvic Pain Society
CANADIAN RESOURCES:
Health Canada
The Society of Obstetricians and Gynecologists of Canada
References
- Chronic pelvic pain. The American Congress of Obstetricians and Gynecologists website. Available at: https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2020/03/chronic-pelvic-pain.
- Chronic pelvic pain. Family Doctor—American Academy of Family Physicians website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/chronic-pelvic-pain.html.
- Chronic pelvic pain in women. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/chronic-pelvic-pain-in-women.
- Speer LM, Mushkbar S, et al. Chronic Pelvic Pain in Women. Am Fam Physician. 2016 Mar 1;93(5):380-387.
Contributors
- James P. Cornell, MD
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