Chronic Pelvic Pain

By Medically reviewed by hellodoktor


What is chronic pelvic pain?

Chronic pelvic pain is a pain in the area below your bellybutton and between your hips. It is a chronic pain because it can last six months or longer. In some cases, it is a mild ache that comes and goes. But in other cases, the pain is steady and severe that it causes problems to sleep, work, or daily tasks.

Chronic pelvic pain can have multiple causes. It can be a condition in its own right or is a symptom of another disease.

If your chronic pelvic pain is caused by another medical problem, treating that problem may be enough to make your pain go away.

Unfortunately, in most cases, it’s not possible to identify the exact cause of chronic pelvic pain. Therefore, the goal of treatment is to reduce your pain and other symptoms and improve your quality of life.

How common is chronic pelvic pain?

This health condition is extremely common. It commonly affects more females than males. It can be managed by reducing your risk factors. Please discuss with your doctor for further information.


What are the symptoms of chronic pelvic pain?

The common symptoms of chronic pelvic pain are:

  • Vaginal discharge having an unusual color, texture, or odor
  • Abdominal or pelvic pain in a specific area or more widespread
  • Pain during sex
  • Irregular or missed periods
  • Menstrual cramps that are worse than usual
  • Frequent need to urinate
  • Pain when you urinate
  • Pain when you ovulate
  • It hurts when you press on certain areas of your pelvis
  • Lower back pain
  • Fatigue
  • Fever
  • Nausea

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.


What causes chronic pelvic pain?

Chronic pelvic pain is a complex disease which can have multiple causes. Sometimes, a single disorder may be diagnosed as the cause.

However, on the other hand, pain may come from several medical conditions. For example, a woman might have both endometriosis and interstitial cystitis in chronic pelvic pain.

Some causes of chronic pelvic pain include:

  • Endometriosis. This is a condition in which tissue from the lining of your womb (uterus) grows outside your uterus, leading to thickening, breaking down and bleeding each month as your hormone levels rise and fall.
  • Tension in your pelvic floor muscles. Spasms or tension in the pelvic floor muscles can lead to recurring pelvic pain.
  • Chronic pelvic inflammatory disease. With a long-term infection, the infection can cause scarring that involves your pelvic organs.
  • Ovarian remnant. After surgical removal of the uterus, ovaries and fallopian tubes (which is a small piece of ovary) may accidentally be left inside and develop painful cysts.
  • Fibroids. These noncancerous uterine developments may cause pressure or a feeling of heaviness in your lower abdomen.
  • Painful bladder syndrome (interstitial cystitis). This condition can lead to pain in your bladder and a frequent need to urinate. You may suffer from pelvic pain as your bladder fills, which may improve temporarily after you empty your bladder.
  • Pelvic congestion syndrome. Some doctors believe enlarged, varicose-type veins around your uterus and ovaries may cause pelvic pain.
  • Psychological factors. Depression, chronic stress or a history of sexual or physical abuse may make your risk of chronic pelvic pain become higher.
  • Emotional distress makes pain worse and living with chronic pain contributes to emotional distress. These two factors often become a vicious cycle.

Risk factors

What increases my risk for chronic pelvic pain?

There are many risk factors for chronic pelvic pain, such as:

  • History of pelvic inflammatory disease.
  • History of physical or sexual abuse. About half of women with chronic female pelvic pain report abuse in their past.
  • History of radiation treatment or surgery of the abdomen or pelvis. This includes some surgeries for urinary incontinence.
  • History of depression. Pain and depression seem to be related.
  • Alcohol or drug abuse.
  • Something abnormal in the structure of the female organs.
  • Pregnancy and childbirth that put stress on the back and pelvis, such as delivery of a large baby, a difficult delivery, or a forceps or vacuum delivery.

Diagnosis & Treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.


How is chronic pelvic pain diagnosed?

Pelvic pain is diagnosed by:

  • Pelvic exam. This can show you signs of infection, abnormal growths or tense pelvic floor muscles.
  • Lab tests. During the pelvic exam, your doctor may recommend labs to check for infections, such as chlamydia or gonorrhea. Your doctor may also suggest blood tests to check your blood cell counts and urinalysis to check for a urinary tract infection.
  • Ultrasound. This test uses high-frequency sound waves to produce precise images of structures within your body. This diagnosis is useful to detect masses or cysts in the ovaries, uterus or fallopian tubes.
  • Other imaging tests. Abdominal X-rays, computerized tomography (CT) scans or magnetic resonance imaging (MRI) can be suggested by your doctor to help identify abnormal structures or growths.
  • Laparoscopy. During this surgical procedure, your doctor makes a small incision in your abdomen and let a thin tube with a small camera insert in it. (laparoscope). The laparoscope helps your doctor observe your pelvic organs and check for abnormal tissues or signs of infection. This procedure is especially useful in detecting endometriosis and chronic pelvic inflammatory disease.

How is chronic pelvic pain treated?

Chronis pelvic pain can be treated by:

  • Medications
  • Physical therapy, neurostimulation (spinal cord stimulation), trigger point injections, psychotherapy
  • Surgery
  • Pain rehabilitation programs
  • Acupuncture

Lifestyle changes & Home remedies

What are some lifestyle changes or home remedies that can help me manage chronic pelvic pain?

The following lifestyles and home remedies might help you cope with chronic pelvic pain:

  • Practicing safe sex
  • Getting tested for sexually transmitted infections
  • Avoiding douches
  • Wiping from front to back after using the bathroom to prevent bacteria from entering your vagina

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: March 12, 2017 | Last Modified: September 12, 2019

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