HealthInfo Waitaha Canterbury
Long-lasting (chronic) pelvic pain
Pelvic pain means pain in the area below your tummy button and above your legs. Long-lasting (chronic) pelvic pain describes pain in your pelvis that has lasted for six months or more. It's a common problem for women. It doesn’t include pregnancy-related pain, or pain you only get when you have your period or have sex. Chronic pelvic pain can be distressing and have a huge impact on your life.
Causes of long-lasting (chronic) pelvic pain in women
Chronic pelvic pain is often not due to one cause but rather a combination of factors. It can be difficult to diagnose and in many cases no cause can be found.
Possible factors include:
- endometriosis
- tight or spasmed muscles
- irritable bowel syndrome
- an inflamed bladder (interstitial cystitis)
- pelvic inflammatory disease
- scarring from previous surgery (often called adhesions)
- trapped or damaged nerves in your pelvic area
- depression.
Diagnosing long-lasting (chronic) pelvic pain in women
Your doctor will ask you all about what makes your pain better or worse, and how it affects your mood, everyday activities, work and sleep. They may suggest you fill out:
- a pain diary – a written record to help you keep track of symptoms or activities associated with pain
- a pelvic pain questionnaire
- a period diary. You can also download a period tracker app, called Clue, for iPhones and Android phones, or Period Tracker for Android phones.
These all help your doctor understand more about your pain and how it affects you.
They will probably examine your tummy, do an internal (vaginal) examination and check your joints for tenderness.
Based on what they find they may do more tests, including taking a urine sample to check if you have a urine infection, and blood tests and swabs to check for other infections.You might also be sent for an ultrasound scan. If you have not yet reached menopause you will have a pregnancy test.
Often, no obvious cause for your pain can be found, but having more information can help you and your doctor decide on the best treatment.
Treating long-lasting (chronic) pelvic pain in women
Treatment will depend on the cause of your pain. Your doctor may refer you to a specialist doctor called a gynaecologist for further investigations and treatment. If this is the case, they may ask you to complete a pelvic pain questionnaire before your appointment so the doctor can understand more about your pain and how it affects your life.
If doctors cannot find a cause, they may recommend medication combined with lifestyle changes, counselling, and physiotherapy. Treatment will focus on finding ways for you to deal with the pain so that it doesn't have such a big impact on your life. The video Understanding pain (what to do about it in less than five minutes) explains some of things you can do to reduce the impact of pain on your life.
You may choose to see a private gynaecologist, a physiotherapist specialising in pelvic problems, or a psychologist.
Long-lasting (chronic) pelvic pain can be very difficult to live with. You may experience depression, difficulty sleeping and disruption to your daily routine. Talk to your GP if this is the case.
HealthInfo recommends the following videos
- Chronic pain Is a disease
In this TED video paediatric anaesthesiologist Elliot Krane explains the "positive feedback loop" of chronic pain, and what it feels like for sufferers.
HealthInfo recommends the following pages
- Pelvic Pain Foundation of Australia – Understanding long-term (chronic) pelvic pain
This page explains how chronic pelvic pain can develop and the effect it can have on your life.
Written by HealthInfo clinical advisers. Last reviewed September 2021.
Sources
Review key: HIPPA-13407
