As a woman, you may from time to time or month to month experience some pain in your pelvic area—that area below your belly button and above your legs. A lot goes into your pelvic area. It’s home to various organs, has the potential to carry life and more.
But what do you do when pelvic pain becomes persistent? Could it be lingering period cramps or does your chronic pelvic pain indicate something else?
What is chronic pelvic pain?
“Chronic pelvic pain is any pelvic pain that lasts for more than six months and occurs in the pelvis or lower abdomen,” said Mohammad Islam, MD, a minimally invasive gynecologic surgeon with Banner Health Center in Phoenix, AZ. “Sometimes the cause of the pain is not obvious. At other times, the problem, which originally caused the pain, has lessened or even gone away completely, but the pain continues.”
Chronic pelvic pain may be caused by a number of diseases or conditions and due to several organ systems, such as gynecological, neurological, vascular, musculoskeletal and gastrointestinal. Below is a breakdown of some of the most common gynecologic causes.
8 potential causes for chronic pelvic pain
Endometriosis
Endometriosis occurs when the tissue lining your uterus grows outside on other organs, such as the ovaries or bladder. It will act much like regular uterine tissue does during your period and can cause mild to severe pain.
Adenomyosis
Similar to endometriosis, adenomyosis grows into the muscular layer of the uterus and thickens it. As this layer thickens, women may experience heavier and longer-than-usual periods, cramping and pain during sex.
Recurrent ovarian cysts
Ovarian cysts occur when one of your eggs fails to release. When this happens, a growth called a cyst can form. Some women may be unaware, while others may experience a dull and sharp pain radiating in their lower backs, abdominal bloating, pressure or a sense of fullness in their pelvic area. Women may also experience pain during sex or issues with their bladder and bowels.
Uterine fibroids
Fibroids are benign (noncancerous) masses that can grow within the uterus and are quite common in women. Many women won’t experience any symptoms, but for some women, it can drastically impact their lives. Uterine fibroids may cause excessive bleeding or cramping during your period, constipation and pain during sex.
Pelvic inflammatory disease (PID)
Pelvic inflammatory disease (PID) is an infection of the uterus, fallopian tubes or ovaries that is most often due to complications of sexually transmitted infections, such as chlamydia and gonorrhea. Along with pelvic pain, you may experience abnormal vaginal discharge and bleeding. Worst off, if left untreated, it can carry consequences like infertility and permanent damage to your reproductive organs.
Pelvic floor dysfunction
Your pelvic floor is a group of muscles, ligaments and tissues located between your tailbone and your pubic bone and is integral in the support of all the organs in your pelvis, which includes the bladder, rectum, urethra, uterus and vagina. When that area becomes weak or inflamed, a host of symptoms can occur, including pelvic pain, incontinence, pain during sex and issues with your bowel and bladder. Some common conditions that may be associated with pelvic floor dysfunction in women include endometriosis, previous deliveries, pelvic organ prolapse and symphysis pubis dysfunction.
Pelvic congestion syndrome (PCS)
Pelvic congestion syndrome (PCS) is a vascular disorder that is a common cause of pelvic pain. PCS occurs when blood backs up into the veins of the pelvis and they become enlarged. Symptoms include chronic pelvic pain and pressure, pain during sex, issues with your bowel and bladder and pain when sitting or standing.
Bladder inflammation
When your bladder is inflamed it can create pain in your pelvis that may include painful urination, discomfort and pain during sex. The cause could be due to interstitial cystitis (IC) or a urinary tract infection.
How is chronic pelvic pain diagnosed and treated?
Before you self-diagnose based on the above symptoms, it’s best to consult your doctor so they can ask more detailed questions about your symptoms, go over your medical history and perform any necessary physical exams.
“Depending on where the symptoms are presenting, the physical exam may include a pelvic exam and an examination of your back, abdomen and extremities,” Dr. Islam said. “Also, additional testing may include vaginal swabs, blood tests and imaging studies, such as ultrasounds.”
Once a diagnosis has been made, the goal of treatment is to reduce the symptoms and improve your quality of life, which may include a combination of treatments and involve comprehensive care with multiple specialists, including gynecologic surgeons, physical therapists, gastroenterologists, urologists and behavioral health specialists.
“The optimal approach may include medications, physical therapy, neurostimulation, trigger point injections, psychotherapy or surgery,” Dr. Islam said. “If surgery is indicated, it’s important to try to use a minimally-invasive approach, if feasible.”
When to see your doctor
For some instances of pelvic pain, such as mild menstrual cramping, it may not be necessary to seek medical care. However, if you experience severe and steady pain, sharp or shooting pain, pain that comes and goes or dull aching, pressure or heaviness during intercourse, bowel movements or positional changes, talk to your doctor. To find a Banner Health specialist near you, visit bannerhealth.com.
