Chronic pelvic pain: Causes, symptoms and treatments

You should consult your doctor to determine the cause of your pelvic pain and discuss treatment options.

Many women experience pelvic pain, which occurs in the lowest part of the abdomen, below the belly button and above the legs. This can be categorized as either chronic or acute, depending on the severity and frequency, and it may feel like a dull ache or a sharp pain. The pain could be related to a particular event, or there may be other underlying causes. To help you better understand how to recognize and address chronic pelvic pain, here's some information on the causes, symptoms and treatments.

Chronic pelvic pain vs. acute pelvic pain

Pelvic pain is considered chronic if it lasts for longer than six months. This type of pain can come and go, or it can be constant. One in seven women in the United States is affected by pelvic pain that's chronic. Acute pelvic pain, on the other hand, is often sudden and severe, and it typically lasts less than three months.

Common causes of pelvic pain for women

There are several different causes of pelvic pain. Some are related to reproductive organs, while others are tied to the urinary tract or bowel, according to the American College of Obstetricians and Gynecologists.

Common causes of pelvic pain include:

• Menstruation: Many women experience cramps during their menstrual cycle.
• Endometriosis: Endometriosis is when the tissue that normally grows inside the uterus grows in other parts of the body, such as the ovaries, pelvis or bladder. During menstruation, this tissue swells and bleeds, which can be painful.
• Uterine fibroids: Fibroids are noncancerous growths on the muscular wall of the uterus. They can be small or large and are often painful.
• Pelvic inflammatory disease (PID): Pelvic inflammatory disease is an infection in the female reproductive organs. If the cervix becomes exposed to a sexually transmitted infection, it allows bacteria to travel to the internal organs, which may become inflamed and infected. This can damage the fallopian tubes and may cause pain and infertility, according to the American Academy of Family Physicians.

Common symptoms of chronic pelvic pain

The primary symptom of chronic pelvic pain is the pain itself. The frequency and severity of the pain can vary from woman to woman. It might occur during or after sex, during urination or after eating. Other symptoms could be tied to additional issues. For example, if your pelvic pain is due to endometriosis, you may experience abdominal bloating, painful bowel movements or spotting between periods. If the pain is related to an infection, such as a urinary tract infection, you may feel pressure in your lower pelvis or need to urinate frequently. You might also experience lower back pain.

Getting a diagnosis

You should consult with your doctor to determine the cause of your pelvic pain and discuss treatment options. They might ask you questions such as:

• When and where do you feel pain?
• How long does the pain last?
• What does the pain feel like?
• Is the pain related to your menstrual cycle, urination or sexual intercourse?

Your doctor will likely give you a physical exam that includes a pelvic exam. They may also run imaging tests, such as an ultrasound, which can reveal ovarian cysts or uterine fibroids that may be causing your pelvic pain. Another imaging test your doctor might run is a colonoscopy, which can help your doctor determine if your pelvic pain is related to a gastrointestinal issue, such as irritable bowel syndrome (IBS). IBS occurs when the intestines squeeze too hard or not hard enough, causing food to move too quickly or too slowly through the intestines.

Treating pelvic pain

Chronic pelvic pain can be treated in several ways, but the treatment will depend on your preference, your overall health and the cause of the pain, among other factors.

Potential treatments include:

• Analgesics, such as acetaminophen or nonsteroidal anti-inflammatory drugs
• Antibiotics
• Oral contraceptives, which are effective for treating dysmenorrhea (pain during menstruation) associated with endometriosis
• Physical therapy, acupuncture, acupressure or nerve stimulation therapy to ease muscular pain at trigger points
• Surgery, often to treat endometriosis

If you've been experiencing pelvic pain that lasts for more than six months, don't wait to talk to your doctor. The sooner you get a diagnosis, the sooner you can start seeking relief.