Pelvic Pain

Pelvic pain at a glance

• Pelvic pain is a general term to describe pain in the area between the hips and below the navel.
• If a woman has had pelvic pain (whether constantly or on-and-off) for six months or longer, it is considered chronic pelvic pain.
• A wide range of problems in the reproductive, urinary, and/or digestive systems can cause pelvic pain, as well as a history of physical or sexual abuse. For some women, a specific cause of pelvic pain may not be identified.
• Treatment for pelvic pain depends on the cause of the pain. If no specific cause is identified, the pain is still treatable.
• Managing chronic pelvic pain may require a combination of medication, therapy, and stress reduction.
  

Pelvic pain symptoms

The symptoms of pelvic pain may differ from one woman to another. Some women experience pain that is so severe that everyday responsibilities are difficult to manage, while others feel a mild irritation. Pelvic pain may be:

• A dull ache
• A sharp, cramping sensation
• Intense and constant
• On-and-off (intermittent)

The discomfort may also feel like heaviness, fullness, or pressure in the lower abdomen.

Symptoms of pelvic pain may worsen during:

• Intercourse
• Bowel movements or urination
• Long periods of standing or sitting

Sudden pelvic pain

See a health care provider immediately if you have sudden, severe pelvic pain. This may be a sign of a serious health emergency.

Causes of pelvic pain

Pelvic pain can be caused by a variety of conditions in the lower abdominal region, including the reproductive, urinary, and digestive organs.

Some common causes of pelvic pain include:

• Pelvic floor muscle spasms/tension
• Chronic pelvic inflammatory disease
• Adenomyosis and/or endometriosis (conditions where the tissue that lines the uterus grows into the walls of the uterus or in other parts of the lower abdomen)
• Ovarian remnants (a small piece of ovary left behind after a complete hysterectomy)
• Uterine fibroids (non-cancerous growths in the uterus)
• Irritable bowel syndrome
• Interstitial cystitis (chronic inflammation of the bladder)
• A history of physical or sexual abuse, depression, or chronic stress

Neuropathic pain, when damaged nerves continue to send pain signals after a disease or an injury has healed, may also be a cause of pelvic pain.

Determining the cause of pelvic pain can be challenging and in some cases a physician will not be able to pinpoint a specific cause. Nevertheless, pelvic pain is a valid concern that affects a woman’s well being, and can be treated even if a cause is not identified.

Treatment for pelvic pain

Treatment for pelvic pain depends on the woman’s symptoms and underlying conditions.

For most women with chronic pelvic pain, a combination of treatments, medications, and pain management techniques will be the most effective source of relief from their symptoms. It may take a process of trial and error to discover the combination that works best.

Some methods of treatment for pelvic pain include:

• Pain medication (over-the-counter and/or prescription)
• Birth control pills or other hormonal medications
• Antidepressants
• Antibiotics
• Transcutaneous electrical nerve stimulation (TENS)
• Trigger point injections
• Physical therapy
• Laparoscopic surgery to remove pelvic adhesions or endometrial tissue.

Counseling can provide techniques for managing the stress, depression, and/or anxiety of living with chronic pain as well.