What is chronic pelvic pain? Learn 10 important causes

Chronic pelvic pain is long-lasting discomfort in the lower abdomen or pelvis. It occurs below the belly button and between the hips. The pain usually lasts six months or longer. It can have many possible causes. Sometimes it is linked to another medical condition. In other cases, no clear cause is found. Treatment focuses on managing symptoms. Let’s explore this condition in more detail below.

What is chronic pelvic pain?

Chronic pelvic pain is persistent pain felt in the lower abdomen or pelvis. It lasts six months or more. The pain may be constant or come and go, and it can range from a dull ache to sharp or severe discomfort.

It can affect both men and women and may be linked to problems involving the bladder, bowel, reproductive organs, muscles, or nerves. In some cases, no clear cause is found, and the pain itself becomes the main condition needing treatment.

What are the symptoms of chronic pelvic pain?

Chronic pelvic pain can affect different areas of the lower belly and pelvis. People describe it in many ways, such as:

• Long‑lasting pain that doesn’t go away
• Pain that comes and goes over time
• A persistent ache deep in the pelvic region
• Sharp, cramping sensations
• A pressure feeling in the abdomen

You may notice the pain more during everyday activities, including:

• During or after sexual intercourse
• When urinating or having a bowel movement
• After sitting or standing for long periods

The severity of chronic pelvic pain varies. For some, it may be mild. For others, it can be strong enough to interfere with sleep, work, or exercise.

Other symptoms often linked with chronic pelvic pain may include:

• Frequent or urgent need to urinate
• Bloating or swelling in the lower abdomen
• Nausea or an upset stomach
• Constipation or diarrhea

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What are the causes of chronic pelvic pain?

Chronic pelvic pain can be tricky. Sometimes it comes from a single medical condition. Other times, several issues add up to cause the pain. You might have more than one condition at the same time, like endometriosis and interstitial cystitis.

Here are some common causes:

• Endometriosis: It’s a tissue like the uterus lining outside the uterus. It causes pain and affects fertility.
• Muscle and joint problems: Tight pelvic muscles, fibromyalgia, joint swelling, or hernias can make pelvic pain worse.
• Nerve problems: Nerves in the pelvis can get trapped or damaged. This may happen after surgery, injury, or repetitive activities like cycling or long hours of sitting. Pudendal nerve pain is one example.
• Chronic infections: Long-lasting infections, sometimes sexually transmitted, can scar organs in the pelvis and lead to ongoing pain.
• Leftover ovarian tissue: Occasionally, small pieces of the ovary remain after surgery. These can form painful cysts later.
• Fibroids: Non-cancerous growths on or in the uterus may create pressure or heaviness in the lower belly or back.
• Irritable bowel syndrome (IBS): Digestive issues like bloating, constipation, or diarrhea can add to pelvic discomfort.
• Painful bladder syndrome: Also called interstitial cystitis, it causes bladder pain, frequent urination, and pelvic pressure. Pain may increase as the bladder fills and improve after emptying.
• Pelvic congestion: Enlarged veins around the uterus or ovaries can cause a dull, aching pain.
• Emotional factors: Stress, anxiety, depression, or a history of trauma can make pain worse. Long-term pain can also increase emotional strain, creating a cycle of discomfort.

Gender-specific differences in chronic pelvic pain

Symptoms of chronic pelvic pain can vary between men and women because of differences in anatomy and physiology.

Chronic pelvic pain in women is linked to conditions like inflammatory disease in the pelvic area, ovarian cysts, and endometriosis. Pain may also be influenced by the menstrual cycle, with many women noticing increased discomfort during menstruation or ovulation.

Chronic pelvic pain in men is commonly associated with issues like prostatitis or pelvic floor dysfunction. Men may experience pain during urination or ejaculation, along with discomfort in the lower abdomen or genital area.

Understanding these gender-specific patterns can help guide diagnosis and treatment, ensuring that both men and women get the care they need.

How to diagnose chronic pelvic pain?

Diagnosing chronic pelvic pain starts with a detailed conversation. Your healthcare provider will ask about your symptoms, how long the pain has lasted, and your medical history. A physical examination is then carried out to look for areas of tenderness or discomfort.

Your doctor will pay close attention to warning signs, such as sudden or severe pain, fever, or unusual symptoms. These may point to conditions that need urgent care, including appendicitis, ectopic pregnancy, ovarian torsion, or pelvic infections.

During the exam, the abdomen and pelvic area are gently checked to assess muscles, tissues, and organs. A pelvic examination may also be done to examine the vagina, cervix, uterus, and ovaries. Together, your symptoms and exam findings help guide the next steps.

Additional tests may be recommended, such as:

• Laboratory tests: Urine and blood tests can help detect infections, pregnancy, kidney stones, or inflammation.
• Imaging scans: Pelvic ultrasound is commonly used to identify cysts, growths, or structural problems. CT scanners and MRIs are utilised for a detailed view.
• Laparoscopy: A minimally invasive procedure that allows doctors to look inside the pelvis for possible causes of pain.
• Bladder or bowel tests: Procedures such as cystoscopy or colonoscopy may be used if bladder or digestive causes are suspected.

These tests help narrow down possible causes and guide the most appropriate treatment plan.

How to treat chronic pelvic pain?

Treatment for chronic pelvic pain depends on what is causing it. If an underlying condition is identified, care is focused on treating that problem directly. For example, hormone-based treatments may be used to reduce pain linked to menstrual cycles, while surgery may be considered for conditions such as endometriosis or fibroids.

When no clear cause is found, treatment focuses on managing symptoms and improving day-to-day comfort. This may include:

• Pain relief medications: Anti-inflammatory medicines and muscle-relaxing drugs are commonly used. Treatment usually avoids long-term reliance on strong painkillers.
• Hormonal therapies: These can help control pain related to hormonal changes and may be given as tablets, injections, or hormone-releasing devices.
• Lifestyle adjustments: Improving diet, staying active, and maintaining good posture can help reduce symptoms over time.
• Physical support: Heat therapy, rest, and pelvic floor physiotherapy may ease muscle tension and discomfort.
• Emotional support: Speaking with a counselor or therapist can help you cope with chronic pain and its effects on mood, relationships, and overall well-being.

Most treatment plans combine several approaches to help relieve pain and improve quality of life.

Conclusion

Chronic pelvic pain is a complex condition that can affect daily life in many ways. It may have a clear cause or develop without an obvious reason, and symptoms can differ from person to person. With the right evaluation and a personalised treatment plan, many people find relief and regain control over their quality of life. Early assessment, ongoing support, and a combination of medical and lifestyle approaches play an important role in managing this condition effectively.

Facing any chronic pelvic pain? Do not fret!!! Consult our health care provider now.

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