Chronic Pelvic Pain—Female
(Pelvic Pain, Chronic)
Pelvic pain is between the belly button and the hips and groin. If it lasts for 6 months or more it is called chronic pelvic pain.
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A wide variety of chronic conditions or injuries can cause pelvic pain:
- Problems of sexual organs or related conditions, such as:
- Problems with the intestines such as:
- Urinary conditions, such as:
- Injuries to muscles, nerves, hips, or back
Pain can also be made worse by mental health conditions, like depression.
For some, the cause of the pain is not clear.
Factors that may increase your risk of chronic pelvic pain include:
Pain can vary from person to person. Chronic pelvic pain may include:
- Constant pain or dull ache in the pelvic area
- Burning, shooting pain
- 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
Tests and examination may be needed if the cause is not known. Tests may include:
- Blood tests
- Urine tests
- Imaging tests (such as x-rays and ultrasound)
- Minimally invasive surgeries—to view or test tissue
The doctor will also ask about your health history. You will also be asked about the pain. The doctor will want to know when it occurs, how it feels, and how long it lasts. A pain journal may help show important details.
If the cause is known, treatments will be focused the cause.
Pain management may be needed. It may be needed if the cause is not clear or treatment is not yet working for pain.
Medicine may help to manage some pain. You and your doctor will work to find the lowest dose for you. This will help manage pain and decrease the risk of side effects. Options may include:
- Prescription pain medicine—may be recommended for severe pain
- Nonsteroidal anti-inflammatory drugs (NSAIDs)—may help manage pain and reduce inflammation
- Hormones—for pain related to the reproductive system
- Antidepressants and anti-seizure medicines—may help manage certain types of chronic pain
A nerve block may be recommended. It is reserved for severe pain that is making daily tasks difficult. An anesthesia medicine is given through a needle. It will be injected near the nerve that is sending pain signal to the brain. It will temporarily block the pain.
Therapies that may help in managing pain include:
- Relaxation therapy—reduces tension which can increase pain levels
- Biofeedback—retrains how your body reacts to pain
Counseling can be helpful for chronic pain. Stress and tension can increase the sensation of pain. Unhealthy thought patterns can also make it more difficult to manage pain. Counseling can help you form healthy thought patterns. You can also learn relaxation and coping strategies. This therapy may reduce the sensation of pain and its impact on your life.
Prevention will depend on the cause. Some causes are not preventable.
The American Congress of Obstetricians and Gynecologists
The International Pelvic Pain Society
The Society of Obstetricians and Gynecologists of Canada
Chronic pelvic pain. Family Doctor—American Academy of Family Physicians website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/chronic-pelvic-pain.html. Updated April 2014. Accessed June 4, 2015.
Chronic pelvic pain. The American Congress of Obstetricians and Gynecologists website. Available at: http://www.acog.org/~/media/For%20Patients/faq099.pdf?dmc=1&ts=20130611T1540053024. Published August 2011. Accessed June 21, 2016.
Chronic pelvic pain. The International Pelvic Pain Society website. Available at: http://www.pelvicpain.org/docs/patients/Patient-Education-Brochure.aspx. Accessed June 21, 2016.
Chronic pelvic pain in women. EBSCO DynaMed website. Available at:http://www.ebscohost.com/dynamed. Updated April 15, 2016. Accessed June 21, 2016.
Levy BS. The complex nature of chronic pelvic pain. J Fam Pract. 2007 Mar;56(3 Suppl Diagnosis):S16-17.
Reiter RC. Evidence-based management of chronic pelvic pain. Clin Obstet Gynecol. 1998;41(2):422-435.
Last reviewed November 2018 by James Cornell, MD Last Last updated: 4/20/2018