Chronic pelvic pain can be a symptom of another disease or a condition in its own right. Learn how this painful condition is diagnosed and treated.
Chronic pelvic pain is pain in the area below your bellybutton and between your hips that lasts six months or longer.
Chronic pelvic pain can have multiple causes. It can be a symptom of another disease, or it can be a condition in its own right.
If your chronic pelvic pain appears to be caused by another medical problem, treating that problem may be enough to eliminate your pain.
However, in many cases it's not possible to identify a single cause for chronic pelvic pain. In that case, the goal of treatment is to reduce your pain and other symptoms and improve your quality of life.
When asked to locate your pain, you might sweep your hand over your entire pelvic area rather than point to a single spot. You might describe your chronic pelvic pain in one or more of the following ways:
In addition, you may experience:
Your discomfort may intensify after standing for long periods and may be relieved when you lie down. The pain may be mild and annoying, or it may be so severe that you miss work, can't sleep and can't exercise.
With any chronic pain problem, it can be difficult to know when you should go to the doctor. In general, make an appointment with your doctor if your pelvic pain disrupts your daily life or if your symptoms seem to be getting worse.
Chronic pelvic pain is a complex condition that can have multiple causes. Sometimes, a single disorder may be identified as the cause.
In other cases, however, pain may be the result of several medical conditions. For example, a woman might have endometriosis and interstitial cystitis, both of which contribute to chronic pelvic pain.
Some causes of chronic pelvic pain include:
Figuring out what's causing your chronic pelvic pain often involves a process of elimination because many different disorders can cause pelvic pain.
In addition to a detailed interview about your pain, your personal health history and your family history, your doctor may ask you to keep a journal of your pain and other symptoms.
Tests or exams your doctor might suggest include:
Finding the underlying cause of chronic pelvic pain can be a long process, and in some cases, a clear explanation may never be found.
With patience and open communication, however, you and your doctor can develop a treatment plan that helps you live a full life with minimal discomfort.
The goal of treatment is to reduce symptoms and improve quality of life.
If your doctor can pinpoint a specific cause, treatment will focus on that cause. However, if a cause can't be identified, treatment will focus on managing your pain and other symptoms. For many women, the optimal approach involves a combination of treatments.
Depending on the cause, your doctor may recommend a number of medications to treat your condition, such as:
Your doctor may recommend specific therapies or procedures as a part of your treatment for chronic pelvic pain. These may include:
To correct an underlying problem that causes chronic pelvic pain, your doctor may recommend a surgical procedure, such as:
You may need to try a combination of treatment approaches before you find what works best for you. If appropriate, you might consider entering a pain rehabilitation program.
Chronic pain can have a major impact on your daily life. When you're in pain, you may have trouble sleeping, exercising or performing physical tasks.
Chronic pain can also cause anxiety and stress, which in turn may worsen your pain.
Relaxation techniques can help release tension, reduce pain, calm emotions and induce sleep. Many techniques can be learned on your own, such as meditation and deep breathing.
Limited evidence suggests that acupuncture may be helpful for some causes of pelvic pain.
During acupuncture treatment, a practitioner inserts tiny needles into your skin at precise points. Pain relief may come from the release of endorphins, your body's natural painkillers, but that's only one of many theories about how acupuncture works. Acupuncture is generally considered a safe treatment.
Talk with your doctor if you're considering trying a complementary or alternative therapy.
You're likely to start by seeing your family doctor or a doctor who specializes in conditions affecting the female reproductive tract (gynecologist).
Depending on the suspected cause of your pain, he or she may refer you to a digestive system specialist (gastroenterologist), a urinary and gynecologic specialist (urogynecologist) or a specialist in musculoskeletal pain (physiatrist or physical therapist).
To prepare for your appointment:
Some basic questions to ask your doctor include:
In addition to the questions you've prepared in advance, don't hesitate to ask questions during your appointment at any time that you don't understand something.
Your doctor will likely ask you a number of questions. Being ready to answer them may leave extra time to go over any points you'd like to have clarified. Your doctor may ask: