• Chronic Pelvic Pain—Female

    (Pelvic Pain, Chronic)

    Definition

    Pelvic pain is located between the belly button and the hips and groin. If it lasts for 6 months or more it is called chronic pelvic pain.
    Pelvic pain can be caused by problems in any of the organs, soft tissues, or structures in the area including the reproductive organs, intestines, nerves, bladder, or muscles.
    Female Pelvic Organs
    IMAGE
    Copyright © Nucleus Medical Media, Inc.

    Causes

    A wide variety of chronic conditions or injuries can cause pelvic pain:
    Psychological conditions, such as depression, can also increase the sensation of pain or cause pain with normal action.
    For some, the cause of chronic pelvic pain is not clear.

    Risk Factors

    Factors that may increase your risk of chronic pelvic pain include:

    Symptoms

    Pain can vary significantly from person to person. Chronic pelvic pain may include:
    • Constant pain or dull ache in the 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

    Chronic pain is diagnosed after it has been present for at least 6 months. 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), or minimally invasive surgeries to examine the area.
    The doctor will also ask about your medical history and details about the pain such as when it occurs, how it feels, and how long it lasts. A pain journal may help show important details.

    Treatment

    If the cause is known, treatments will be focused on treating the underlying cause. These may include counseling, medication and/or surgery.
    Pain management can help with pain that does not fully respond to treatment of related conditions or pain with no clear cause. Options include:

    Medications

    Medication may help manage some pain. You and your doctor will work to find the minimum dose to decrease risk of side effects. Medication options may include:
    • Prescription pain medication 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 medications have been shown to help manage certain types of chronic pain.
    Severe pain that is interfering with daily activity may need a nerve block. With a nerve block, an anesthesia medication is injected near the nerve that is signaling pain to temporarily block the pain.

    Complementary Therapies

    Therapies that may help in managing pain include:
    • Relaxation therapy—tension can increase the sensation of pain
    • Acupuncture
    • Biofeedback—retrain how your body reacts to pain

    Psychological Counseling

    Counseling can be helpful in managing chronic pain. Stress and tension can increase the sensation of pain. Unhealthy thought patterns can also develop which can make it more difficult to manage pain. Psychological counseling can help you form healthy thought patterns, and teach you relaxation and coping strategies. This therapy may reduce the sensation of pain and its impact on your everyday life.

    Prevention

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

    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 Gynecologists of Canada http://www.sogc.org

    References

    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.

    Revision Information

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