Chronic Pelvic Pain

Chronic Pelvic Pain

August 11, 2013  |  Women's Health

What is it?

Chronic pelvic pain is pain in the area between your hips and below your belly button that lasts 6 months or longer. Approximately 10 to 20% of women of childbearing age suffer with this condition.

What are the Symptoms?

Pelvic pain can present in a variety of ways and it may change over time. Some women describe their pain as a sharp pain that comes and goes, cramping, dull aching or constant pressure in the pelvis or, more commonly, they feel a combination of all these.

You may feel it spread across your pelvic area or localized to one specific point. It may be constant, intermittent or cyclic, often related to your menstrual cycles. You may also experience pain during sexual activity, urination, bowel movements or physical activity.

Although some women have mild pain that they can tolerate, others struggle with severe pain that significantly affect their daily living activities.

What are the causes?

There are multiple causes for chronic pelvic pain, many involving the reproductive organs. Other causes are problems in your bladder, bowels or pelvic muscles and nerves.

Your heath care provider will use your medical history, physical examination and additional tests to identify why you have pelvic pain. Keep in mind that it is not unusual to have more than one problem causing the pain and that sometimes no explanation is found. Even when no reason is found for the pain, you can still be treated and feel better.

Some of the most frequent causes of chronic pelvic pain are:

  • Endometriosis – occurs when the tissue that lines the cavity of the uterus grows outside of the uterus, most commonly in the pelvis. It is the most common cause of gynecological chronic pelvic pain and it may also cause infertility.
  • Pelvic inflammatory disease – is usually caused by sexually transmitted diseases such as chlamydia and gonorrhea. Some women develop chronic pain after one or multiple episodes of infection.
  • Irritable bowel syndrome – gastrointestinal condition where pain is associated with altered bowel habits such as frequent loose stools or constipation.
  • Pelvic floor pain and myofascial pain syndrome – muscle spasms in your pelvis, abdominal wall, hips or lower back may cause pelvic pain. Trigger points in these muscles can be identified and treated.
  • Uterine fibroids – although most women with fibroids do not feel pain, they can be a cause of pelvic pain, especially during menstruation.
  • Interstitial cystitis and painful bladder syndrome – bladder pain accompanied by frequent and urgent need to void and no infection.

How is it treated?

When possible, the treatment of chronic pelvic pain is guided by what is causing it. When the cause cannot be defined, therapy is aimed at alleviating the pain and improving the quality of life. Treatment may include medications, psychological counseling, physical and nutritional therapy, and surgery.

  • Pain medication – nonsteroidal anti-inflammatory drugs (NSAIDs) are the most commonly and safely used. Opioids and narcotics are rarely used for short periods of time.
  • Hormones – some types of pelvic pain can be treated with birth control pills and other drugs that affect your hormones.
  • Lifestyle changes – weight control, healthy diet and regular exercises.
  • Psychological counseling – it helps in understanding how the pain affects your life and in creating strategies to cope with the pain
  • Physical therapy – especially helpful for muscular pain, helping loosen or relax trigger points. Biofeedback is a technique that might be used to help you control your reaction to the pain.
  • Surgery – some causes of pelvic pain can surgically be treated when other therapies have failed. That is the case for endometriosis, where implants can be destroyed or removed, alleviating the pain.

Who will see patients who have chronic pelvic pain?

Bomtempo, Camila, MD

Bomtempo, Camila, MD

Assistant ProfessorSpecialty: General OB/GYN

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Sumana Koduri, MD

Koduri, Sumana, MD

Associate ProfessorSpecialty: Urogynecology

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Menon, Seema, MD

Menon, Seema, MD

Associate Professor; Director of Obstetrics & Gynecology Clinic; Program Director of Pediatric and Adolescent Gynecology Specialty: General OB/GYN; Pediatric & Adolescent Gynecology

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How does a patient schedule an appointment to be seen for Chronic Pelvic pain?

Please call the Pre-Arrival Department at 414-805-6644.

Medical College of Wisconsin,
Department of Obstetrics & Gynecology
9200 West Wisconsin Ave.,
Milwaukee, WI 53226-3522
Phone: (414) 805-6600
24-Hour Emergency Line: (414) 805-6700

Children's Hospital of Wisconsin

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