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. 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

Causes

Chronic pelvic pain can be caused by a wide variety of conditions.

• Gynecological conditions
  • Endometriosis
  • Pelvic inflammatory disease
  • Fibroids
  • Pain when ovulating
  • Menstrual pain
  • Adenomyosis
  • Cysts
  • Pelvic congestion syndrome

  Female Pelvis Organs From left to right: the bladder, uterus, and colon. Nerves are shown in yellow. © Nucleus Medical Media, Inc.

• Gastrointestinal conditions
  • Diverticulitis
  • Irritable bowel syndrome
  • Constipation
  • Inflammatory bowel disease
  • Cancer
  • Ulcerative colitis

• Urinary conditions, such as a bladder infection or urinary tract infection
• 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:

• Laparoscopy
• Cystoscopy
• Sigmoidoscopy
• Intravenous pyelography
• X-rays
• MRI scan
• CT scan

Treatment

Talk with your doctor about the best treatment plan for you. Options include:

The following have been used to treat pelvic pain:

• Relaxation therapy
• Acupuncture
• Biofeedback
• Transcutaneous electrical stimulation (TENS) therapy
• Massage

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.

You may also be able to reduce your risk of chronic pelvic pain through exercise. If allowed by your doctor, do moderate exercise for at least 30 minutes, 4 days a week.

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

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

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 4, 2015.

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.

Chronic pelvic pain in women. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated March 17, 2015. Accessed June 4, 2015.

Chronic prostatitis/chronic pelvic pain syndrome. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated May 12, 2015. Accessed June 4, 2015.

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.

5/18/2015 DynaMed Systematic Surveillance
http://www.ebscohost.com/dynamed:
Zhang R, Chomistek AK, et al. Physical activity and chronic prostatitis/chronic pelvic pain syndrome. Med Sci Sports Exerc. 2015 Apr;47(4):757-764.