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Chronic Pelvic Pain(Pelvic Pain, Chronic)
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 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

    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.

  • 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
  • Burning, shooting pain
  • Rectal urgency
  • Pain that comes and goes
  • Pain that ranges from mild to severe
  • Pain with certain activities
  • Pain with prolonged sitting
Diagnosis

You will be asked 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 bodily fluids may be tested. This can be done with:

  • Blood and urine tests
  • Cultures and swabs
  • Tests for sexually transmitted diseases (STDs)

Your bodily structures may need to be viewed. This can be done with:

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
  • Prescription pain medication
  • Antidepressants
  • Antiseizure medications
  • Birth control pills
Complementary Therapies

The following have been used to treat pelvic pain:

Interventional Approaches

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

Psychological Counseling

Managing stress through counseling is a helpful way to cope 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.

RESOURCES:

The American Congress of Obstetricians and Gynecologists
http://www.acog.org

The International Pelvic Pain Society
http://www.pelvicpain.org

CANADIAN RESOURCES:

Health Canada
http://www.hc-sc.gc.ca

The Society of Obstetricians and Gynaecologists of Canada
http://www.sogc.org

References:

Chronic pelvic pain. American Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/chronic-pelvic-pain.html. Updated April 2014. Accessed June 18, 2014.

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 18, 2014.

Chronic pelvic pain. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 23, 2014. Accessed June 18, 2014.

Chronic pelvic pain. The International Pelvic Pain Society website. Available at: http://www.pelvicpain.org/docs/patients/Patient-Education-Brochure.aspx. Accessed June 18, 2014.

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 May 2014 by Marcin Chwistek, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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