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Long-lasting (chronic) pelvic pain

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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 6 months or more. It does not include pregnancy-related pain or pain you only get when you have your period or have sex.

Long-lasting pelvic pain is a common problem for women. 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 often no cause can be found.

Possible factors include:

endometriosis
tight or spasmed muscles
irritable bowel syndrome (IBS)
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 about what makes your pain better or worse. Also, 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 (menstrual) diary. You can also download a period tracker app.

These will all help your doctor understand more about your pain and how it affects you.

They will examine your tummy, do an internal (vaginal) examination and check your joints for tenderness.

Based on what they find they may do more tests. These may include 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

The 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 so, they may ask you to complete a pelvic pain questionnaire before your appointment. This is 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.

The treatment will focus on finding ways for you to deal with the pain so it does not 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 general practice team if this is the case.

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