Chronic pelvic pain

Pelvic pain is pain below the belly button. It's chronic if you've had pain for at least 6 months. It may be a mild ache that comes and goes. Or you might have a steady, severe pain that makes it hard to sleep, work, or enjoy life.

Chronic pelvic pain may include:

• Severe cramping during periods.
• Heavy or irregular vaginal bleeding.
• Pain during sex.
• Pain when you urinate or have a bowel movement.
• Pain in certain postures or positions.

The pain can range from mild to severe or from dull to sharp.

Chronic pain can make it hard to sleep, work, or enjoy life. It can lead to depression. Depression can cause you to feel sad or hopeless, eat and sleep poorly, and move slowly.

Your doctor may do a pelvic exam to check for problems with your reproductive system. The doctor will ask questions about your health and your symptoms. You may have tests, such as:

• Blood and urine tests to look for infection and other problems.
• A pregnancy test.
• Tests for sexually transmitted infections (STIs).

Emotional issues can play a big role in chronic pain. So your doctor may ask questions to find out if depression or stress is adding to your problem. You may be asked about any past or current sexual or physical abuse.

If the first tests don't find a cause, you may have other tests to look at organs in your belly. These may include:

• Transvaginal ultrasound.
• MRI.
• CT scan of the pelvis.

You may also have a type of minor surgery called laparoscopy. This lets the doctor look for problems like growths or scar tissue inside your belly.

If your doctor finds a problem that could be causing your pelvic pain, you'll be treated for that problem. Common treatments include:

• Birth control pills or hormone treatment for problems related to your periods.
• Surgery to remove a growth, cyst, or tumor.
• Medicine to treat the problem, such as antibiotics for infection.

Whether or not a cause is found, your doctor can suggest treatments to help manage pain. They include:

• Pain relievers called NSAIDs. These include ibuprofen (such as Advil or Motrin) and naproxen (such as Aleve).
• Antidepressants or anticonvulsants. These can help with pain and with depression.
• Cognitive-behavioral therapy or biofeedback. This may help you change how you think about or react to pain.
• Counseling. It can give you emotional support and reduce stress.
• Physical therapy. It may help you relax your muscles, improve your posture, and be more active.
• Pain relievers that are injected into specific areas to help with pain.

• Be safe with medicines. Read and follow all instructions on the label.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• If you have back pain, lie down and elevate your legs by placing a pillow under your knees. When lying on your side, bring your knees up to your chest.
• Put a warm water bottle, a heating pad set on low, or a warm cloth on your belly. Or take a warm bath. Don't go to sleep with a heating pad on your skin.
• Relax. Try meditation, yoga exercises, or breathing.
• Exercise regularly. It improves blood flow and reduces pain.
• Keep a diary. Track your symptoms, menstrual cycle, sexual activity, and physical activity. Track stressful events or illnesses. This can help your doctor find the cause or treat it.