Definition

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
  • Male Pelvis Organs

    Male pelvis lateral

    Includes bladder, prostate (under bladder), and the colon.

    © 2011 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
  • Female Pelvis Organs

    Female pelvis lateral

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

    © 2011 Nucleus Medical Media, Inc.

        
  • Gastrointestinal conditions     
  • Diverticulitis
  • Irritable bowel syndrome
  • Constipation
  • Inflammatory bowel disease
  • Cancer
  • Ulcerative colitis
  •     
  • Urinary conditions, such as a bladder infection or urinary tract infection
  •     
  • 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
  • Risk Factors

    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

    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
  • Diagnosis

    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
  • Treatment

    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
  • Interventional Approaches

    In some cases interventional approaches, including nerve blocks, may be used.

    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.

    Prevention

    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.