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Chronic Pelvic Pain

Pelvic pain is located between the belly button and the hips and groin. If it lasts for six months or more it is called chronic pelvic pain. It is often difficult to figure out what is the source of the pain. Pelvic pain can be caused by problems in the:

  • Female reproductive organs
  • Intestines
  • Nerves
  • Bladder
  • Prostate

 

Female Pelvis Organs

Female pelvis lateral

From left to right: the bladder, uterus,
and colon. Nerves are shown in yellow.

Copyright © Nucleus Medical Media, Inc.

Causes

Chronic pelvic pain can be caused by a wide variety of conditions.

  • Gynecological conditions
  • Endometriosis
  • Pelvic inflammatory disease
  • Fibroids
  • Pain when ovulating
  • Menstrual pain
  • Adenomyosis
  • Cysts
  • Pelvic congestion syndrome
  • Psychological conditions, such as depression, or a history of physical or sexual abuse
  • Neuromuscular conditions
    • Pudendal neuralgia
    • Muscle pain
    • Nerve pain
    • Lower back pain
    • Joint and bone pain
    • Muscle strain

Are You at Risk?

Having one of the conditions listed above increases your chance of having chronic pelvic pain. Other factors may include:

  • Miscarriage
  • Cesarean section
  • Alcohol or drug abuse
  • Heavy menstrual flow

Symptoms of Chronic Pelvic Pain

Symptoms may include:

  • Constant pain or dull ache in pelvic area
  • Pain that comes and goes
  • Pain that ranges from mild to severe
  • Pain with certain activities
  • Pelvic heaviness
  • Urge to defecate hits suddenly and intensely

Diagnosing Chronic Pelvic Pain

Your doctor will ask about your symptoms and medical history. A physical exam will be done. You may be asked to keep a pain journal to help your doctor diagnose the pain. You will be asked to write down when your pain occurs, how it feels, and how long it lasts. Your doctor may recommend tests to confirm or rule out specific diagnoses.

Tests may include:

  • Blood and urine tests
  • Cultures and swabs
  • Tests for sexually transmitted diseases (STDs)
  • Laparoscopy—a thin, lighted tube inserted into the abdomen to look for infection or disease
  • Cystoscopy—a thin, lighted tube inserted into the bladder to look for abnormalities
  • Sigmoidoscopy—a thin, lighted tube inserted into the rectum to look for abnormalities
  • Intravenous pyelography—type of x-ray that uses dye to look at the kidneys; used to look for damage or disease

Imaging tests to see inside body structures:

  • X-rays
  • MRI
  • CT scan

Pelvic Pain Treatment at UVA

Talk with your doctor about the best treatment plan for you. Options include:

Medications

Chronic pelvic pain is treated based on what caused it:

  • Antibiotics if an infection is present or possible
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) to treat pain and reduce inflammation
  • Opioid pain relievers
  • Antidepressants
  • Antiseizure medications
  • Birth control pills

Complementary Therapies

The following have been used to treat pelvic pain:

  • Relaxation therapy
  • Acupuncture
  • Biofeedback
  • Transcutaneous electrical stimulation (TENS) therapy
  • Massage

Psychological Counseling

Managing stress through counseling is helpful to many women with chronic pelvic pain.

Surgery

There are numerous causes of pelvic pain. Many are treated with surgery. The type of surgery depends upon the specific problem.

How to Prevent Chronic Pelvic Pain

Preventing chronic pelvic pain depends on the condition causing it. Some causes are not preventable.

STDs cause many conditions that result in chronic pelvic pain. Use latex condoms every time you have sexual intercourse, and minimize the number of sex partners you have.

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Call 434.243.3675.

 

Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.

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