Chronic Pelvic Pain in Women

Pain that lasts six months or more in the region between your hips and below your belly button is referred to as chronic pelvic pain. Many factors can contribute to chronic pelvic discomfort. It may be an independent disorder or a sign of another illness.

Treating the underlying medical condition that appears to be the source of your chronic pelvic pain may be sufficient to end your suffering. Unfortunately, it's sometimes impossible to pinpoint a single reason of persistent pelvic discomfort. The aim of treatment in that situation is to lessen your pain and other symptoms while also enhancing your quality of life.

Chronic Pelvic Pain in Women: Causes

Persistent pelvic pain can have a variety of reasons and is a complicated issue. Sometimes the cause is narrowed down to only one condition.

Yet in other instances, a number of medical issues may be to blame for the discomfort. For instance, endometriosis and interstitial cystitis are two conditions that can cause persistent pelvic pain in women.

These are a few reasons of persistent pelvic pain:


This is a disorder when tissue from the uterus' lining develops outside the uterus. Similar to how your uterine lining responds to your menstrual cycle, these tissue deposits thicken, degrade, and bleed each month as your hormone levels increase and decrease.

The blood and tissue cannot leave your body through your vagina since it is occurring outside of your uterus. Rather, they stay in your abdomen where they might result in uncomfortable cysts and fibrous bands of scar tissue (adhesions).

Muscular-skeletal Issues

Recurrent pelvic pain can be brought on by diseases that affect your bones, joints, and connective tissues (musculoskeletal system), such as fibromyalgia, pelvic floor muscle tension, pubic symphysis inflammation, or hernia.

Chronic Pelvic Inflammation

This can happen if a long-lasting infection, which is frequently sexually transmitted, results in pelvic organ-related scarring.

Ovarian Relic

A tiny bit of the ovary may unintentionally remain within after the surgical removal of the uterus, ovaries, and fallopian tubes and subsequently produce uncomfortable cysts.


Your lower abdomen may feel heavy or under strain as a result of these noncancerous uterine growths. They seldom experience intense pain unless they run out of blood and start to die (degenerate).

Bowel Irritability Syndrome

Bloating, constipation, or diarrhoea, which are IBS symptoms, can cause pressure and pain in the pelvic area.

Bladder Pain Syndrome (Interstitial Cystitis)

This illness is characterised by recurrent bladder discomfort and a constant urge to pee. While your bladder fills, you could suffer pelvic discomfort; this pain might momentarily go away after you empty your bladder.

Syndrome of Pelvic Constriction

Some medical professionals think pelvic discomfort may be brought on by swollen, varicose-like veins around your uterus and ovaries. Though the majority of women with enlarged pelvic veins have pelvic discomfort, other medical professionals are far less persuaded that pelvic congestion syndrome is the source of that suffering.

Psychological Determinants

Depression, persistent stress or a history of sexual or physical abuse may raise your risk of chronic pelvic discomfort. Living with chronic pain increases emotional anguish, which in turn worsens pain. These two elements frequently spiral out of control.

Chronic Pelvic Pain in Women: Symptoms

You might not point to a specific part of your pelvis when asked where the pain is located; instead, you could sweep your palm over the whole region. You might use one or more of the following descriptions to describe your persistent pelvic pain −

  • Persistent, severe discomfort

  • Pain that is intermittent (intermittent)

  • A dull ache

  • Sharp discomfort or cramping

  • Feeling of pressure or weight in the deep pelvis

Moreover, you could encounter −

  • Pain during sexual activity

  • Discomfort when peeing or having a bowel movement

  • Sitting for extended lengths of time causes pain

After prolonged standing, your discomfort can worsen; however, lying down might help. The pain might be little and bothersome or it could be so bad that you have to miss work, are unable to rest, and are unable to exercise.

When to Visit a Doctor?

It can be challenging to determine when a chronic pain issue warrants a visit to the doctor. In general, if your pelvic discomfort interferes with your everyday activities or if your symptoms seem to be becoming worse, schedule an appointment with your doctor.

Chronic Pelvic Pain in Women: Risk Factors

Your chance of developing chronic pelvic discomfort may be increased by depression, ongoing stress, or a history of sexual or physical abuse.

Chronic Pelvic Pain in Women: Diagnosis

In order to diagnose chronic pelvic pain in women, the doctor may suggest the following tests −

Pelvic Exam

This may show indications of an infection, unusual growths, or tight muscles in the pelvic floor. Your doctor looks for sore spots. If you have any pain during this check, especially if it is comparable to symptoms you've been having, let your doctor know.

Tests in the Lab

Your doctor may request lab tests to screen for diseases like chlamydia or gonorrhoea during the pelvic exam. Also, your doctor could request a urinalysis to look for a urinary tract infection and bloodwork to evaluate your blood cell levels.


High-frequency sound waves are used in this test to provide clear pictures of the internal organ architecture. This treatment is particularly helpful for finding tumours or cysts in the fallopian tubes, uterus, or ovaries.

Further Imaging Testing

To assist identify abnormal structures or growths, your doctor may advise abdominal X-rays, computed tomography (CT) scans, or magnetic resonance imaging (MRI).


Your surgeon will perform this surgery by making a tiny incision in your belly and inserting a thin tube that is connected to a small camera (laparoscope). The laparoscope allows your doctor to inspect your pelvic organs and look for abnormal tissues or symptoms of infection. The detection of endometriosis and chronic pelvic inflammatory disease is particularly helped by this method.

Chronic Pelvic Pain in Women: Treatment

Your doctor may suggest the following treatments based on the severity of the condition −

  • Drugs that reduce pain. Your pelvic discomfort may be somewhat relieved by over-the-counter pain relievers such aspirin, ibuprofen, or acetaminophen. A prescription painkiller may be required on occasion. Yet, a single painkiller seldom addresses the issue of persistent pain.

  • Hormone therapy. Some women discover that the days they experience pelvic discomfort may be related to a certain time of their menstrual cycle and the hormonal shifts that govern ovulation and menstruation. When this is the case, hormonal drugs such as birth control tablets may ease pelvic discomfort.

  • Antibiotics. Your doctor could advise taking antibiotics if you have an infection that is causing your discomfort.

  • Antidepressants. Antidepressants of a certain type may be beneficial for chronic pain.

Chronic Pelvic Pain in Women: Prevention

One of these is physical therapy. Your persistent pelvic discomfort may be reduced with stretching exercises, massage therapy, and other relaxing methods. These therapies and the creation of pain management techniques can be helped by a physical therapist.


Persistent pelvic discomfort, which affects women more frequently than males, can be incapacitating and persistent. Chronic pelvic discomfort, which is rather frequent, is linked to comorbid conditions such pelvic inflammatory syndrome, major depressive disorder, and irritable bowel syndrome.

Dr. Durgesh Kumar Sinha
Dr. Durgesh Kumar Sinha


Updated on: 30-Mar-2023


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