Chronic pelvic pain refers to pain in the region between your hips, below your bellybutton. In order to be considered chronic, the pain must last for at least six months or longer.
Intensity can vary from being extreme enough to interfere with normal activities, to being relatively mild. The pain may come and go, or be constant; it can be a sharp pain or a dull ache.
The pain may be symptomatic of another condition, or it could be a condition of its own.
Signs and Symptoms
Signs and symptoms that you may be suffering from chronic pelvic pain can include:
- Pain during intercourse
- Cramping or sharp pains
- Heaviness or a feeling of pressure inside the pelvis
- Extreme and constant pain
- Intermittent pain
- A dull ache
- Pain during bowel movements
You may have any one of these symptoms, but most likely you won’t have all of them. You may also find that your pain worsens if you stand for a long period of time, and improves when you lie down. The intensity of the pain will also vary between different women, and even vary within a specific individual.
Possible Causes
Determining the source of the pain can be frustrating and can be a lengthy process. It’s possible that no physical cause for you pain will ever be found. Up to 61% of chronic pelvic pain sufferers will never be specifically diagnosed.
Possible causes for chronic pelvic pain include:
- Endometriosis: A condition that causes tissue from the lining of the uterus to move through the fallopian tubes and grow on the ovaries, bladder and inside of the pelvis. Uterine tissue shrinks and grows throughout the menstrual cycle so pain from endometriosis will increase during the menstrual period.
- Spasms of the muscles in the pelvic floor.
- Chronic Pelvic Inflammatory Disease (PID): This is the result of an infection in the reproductive organs, usually as a result of an STD, such as chlamydia. Causes scarring on the fallopian tubes.
- Fibroids: These are non-cancerous growths inside the wall of the uterus. Fibroids can cause a feeling of pressure on the lower abdomen. They may be small or they may grow as large as a grapefruit. They rarely cause sharp pains unless they being to die.
- Irritable Bowel Syndrome: This condition can cause constipation, bloating and diarrhea and be a source of pelvic pressure and pain.
- Interstitial Cystitis: A chronic bladder problem that causes the wall of the bladder to become swollen and store. It is characterized by a frequent need to urinate; it may cause pelvic pain as the bladder fills, which will be relieved after the bladder is emptied.
- If you have been the victim of sexual abuse, or are depressed or under excessive stress, you may be more susceptible to chronic pelvic pain, possibly from unknowing tensing of your pelvic floor muscles.
Diagnosis
Since there are so many possible causes of chronic pelvic pain, your doctor will probably order a series of tests to try and determine the source of the problem. These can include computed tomography (CT scan), barium enema, ultrasounds, intravenous pyelography (IVP) and magnetic resonance imaging (MRI). If these tests don’t pinpoint where the pain is coming from, a laparoscopy may be necessary.
Treatment: Pain Relief
Possible treatments for chronic pelvic pain include:
- Birth control pills to stop menstruation
- Over the counter pain relief medications, such as ibuprofen or aspirin
- Relaxation exercises, massage or physical therapy
- Antibiotics
- Psychological counseling
- Surgery to correct pelvic abnormalities
- Antibiotics if infection is the source of the pain
- Antidepressants
- Trigger point injections
