Patient education: Chronic pelvic pain in females (The Basics)

What is chronic pelvic pain? — Chronic pelvic pain is internal pain in the area below the belly button that lasts 6 months or longer. It often involves the sex organs (figure 1). Sometimes the pain is related to problems with the intestines (figure 2) or the bladder (figure 3).

What causes chronic pelvic pain? — Chronic pelvic pain can be caused by several medical conditions, including:

●Endometriosis – This is a condition in which cells that should exist only in the uterus begin to grow outside the uterus. People who have endometriosis often have very painful periods. They also sometimes have problems getting pregnant.

●Pelvic inflammatory disease – Pelvic inflammatory disease (PID) is often caused by an infection that is spread through sex. Some people have pain long after the infection starts and is treated. They also can have problems getting pregnant.

●Irritable bowel syndrome (IBS) – This is a condition that affects the intestines and causes both pain and problems with bowel movements. People with IBS usually also have constipation, diarrhea, or both.

●Bladder pain syndrome/interstitial cystitis – This condition causes the bladder to hurt when it is getting full. People with this problem often feel better when they empty their bladder, so they go to the bathroom often.

●Pelvic floor pain – Pelvic floor pain involves the muscles in the pelvic area, which can become tight and tender.

●Fibromyalgia – This is a pain disorder that causes pain in several parts of the body, not just the pelvic area.

Are there tests I should have? — If you have pelvic pain, your doctor or nurse will probably give you a regular pelvic exam. They might also order some blood or urine tests. Depending on your situation, you might also have:

●Pelvic ultrasound – This test uses sound waves to view your pelvic organs. Doctors can use this test to spot fluid-filled sacs (called cysts), abnormal growths, and other problems.

●Laparoscopy – This is a procedure done in an operating room. The doctor makes a small incision near your belly button and inserts a device called a laparoscope. Then the doctor looks through the laparoscope to see if they can find the cause of your pain.

How is pelvic pain treated? — It depends on what is causing your pelvic pain. Possible treatments could include:

●Pain medicines

●Birth control pills

●Change in diet

●Physical therapy to help loosen or relax the muscles in the pelvic area

●"Talk therapy" or other types of counseling, which can help you learn ways to cope and manage the pain

●Surgery to remove the cause of the pain, if possible

You might benefit from treatment at a pain clinic. Pain clinics offer special treatments for pain, such as:

●Trigger point injections – These are shots of medicine that go into specific areas of the muscle.

●Nerve block – This involves shots around certain nerves to block pain

●A device that uses a mild electrical current to block pain – This can be done from the outside, through the skin. In some people, the device is put into the body surgically.

●Biofeedback – This is a technique that helps you learn how to control certain muscles.

●Relaxation exercises

●Acupuncture – This involves having needles inserted into your skin.

More on this topic

Patient education: Chronic pelvic pain in females (Beyond the Basics)