Cassie Health Center for Women

Gynecology >> Pelvic Pain

Chronic Female Pelvic Pain

Female pelvic pain is pain below a woman’s belly button . It is considered chronic, which means long-lasting, if you have had it for at least 6 months. The type of pain varies from woman to woman. In some women, it is a mild ache that comes and goes. In others, the pain is so steady and severe that it’s hard to sleep, work, or enjoy life.

If your doctor can find what’s causing the pain, treating the cause may make the pain go away. If no cause is found, your doctor can help you find ways to ease the pain and get your life back. Some common causes include:

Problems of the reproductive system , such as endometriosis, adenomyosis, and uterine fibroids.
Scar tissue (adhesions) in the pelvic area after a pelvic infection or surgery.
Diseases of the urinary tract or bowel, such as irritable bowel syndrome or chronic bladder irritation.
Physical or sexual abuse. Experts are not sure why this is so, but about half of women with chronic pelvic pain have a history of abuse.*

Doctors don't really understand all the things that can cause chronic pelvic pain. So sometimes, even with a lot of testing, the cause remains a mystery. This doesn't mean that there isn't a cause or that your pain isn't real.

Sometimes, after a disease has been treated or an injury has healed, the affected nerves keep sending pain signals. This is called neuropathic pain. It may help explain why it can be so hard to find the cause of chronic pelvic pain.

The type of pain can vary widely. Chronic pelvic pain can include:

Pain that ranges from mild to severe
Pain that ranges from dull to sharp
Severe cramping during periods
Pain during sex
Pain when you urinate or have a bowel movement.
Chronic pain can lead to depression. Depression can cause you to feel sad and hopeless, eat and sleep poorly, and move slowly.

Diagnosis

At your first visit, your doctor will do a complete pelvic exam to look for problems with your reproductive system. The doctor will also ask questions about your past and present health and about your symptoms. You may have some tests, such as:

A Pap test to look for cervical cancer or cell changes called dysplasia
Blood and urine tests to look for signs of infection
A pregnancy test
Tests for sexually transmitted diseases.

Visit www.acog.org for more information.

*American College of Obstetricians and Gynecologists (2004, reaffirmed 2008). Chronic pelvic pain. ACOG Practice Bulletin No. 51. Obstetrics and Gynecology, 103(3): 589-605.

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