Pelvic pain is pain below the belly button. Chronic pelvic pain means you've had this pain for at least 6 months. The pain can range from a mild ache that comes and goes to a steady pain that makes it hard to sleep, work, or enjoy life.
It can be hard to know what causes this pain. You may need some tests to find the cause. Some common causes include problems with your reproductive system and diseases of the urinary tract or bowel. Sometimes the pain may be related to past or current physical or sexual abuse. But doctors can't always find the cause. This does not mean the pain isn't real or that it's "in your head." It is real pain, and you need to treat it.
If your doctor finds the cause of the pain, you treat the cause. For example, if the cause is hormonal, you might need to take birth control pills. But if the tests don't show a cause, you can take steps to help with the pain.
Chronic pelvic pain is pain in your lower abdomen that lasts for 6 months or more. It may be constant or come and go and range from mild to severe.
Many things can cause chronic pelvic pain, including pelvic infections. But sometimes the cause is a mystery.
It can sometimes be hard to know how long pelvic pain will last and how best to treat it. It's a little different for everyone. But in general:
Chronic pelvic pain may include severe cramping during periods, pain during sex, or pain when you urinate or have a bowel movement. You may have pain in certain postures or positions. Pain may range from mild to severe or dull to sharp.
Treatment for chronic pelvic pain depends on the cause. Common treatments include birth control pills or hormone treatment for problems related to your periods, or surgery to remove a growth, cyst, or tumor. Or you may get medicine to relieve pain or to help treat the problem that's causing the pain.
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:
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:
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.
Medicine won't cure pelvic pain. But it can help control the pain and keep it from getting worse or becoming chronic.
Some medicines help with pain by controlling hormones. They include:
Other medicines used for pain include:
Surgery for pelvic pain is most likely to help when it's done for a specific condition, like fibroids or endometriosis.
Hysterectomy (removing the uterus) is sometimes done as a last-resort treatment. It may relieve pain in some cases, depending on what caused the pain.
With any surgery for chronic pelvic pain—such as hysterectomy or cutting of specific pelvic-area nerves—there's a risk of lasting pain or pain that's worse after surgery. And it can have serious side effects.
During surgery, the doctor may remove scar tissue (adhesions) from previous surgery or from pelvic inflammatory disease or endometriosis. But most studies have shown that this doesn't relieve pain.
Laparoscopy to diagnose chronic pelvic pain may be done before other treatment. Areas of endometriosis or scar tissue may be removed or destroyed during the procedure.
Risk factors are things that increase your chances of getting a certain condition or disease. Risk factors for pelvic pain that becomes chronic include:
Counseling and mental skills training can help when you have chronic pelvic pain. They help you gain the mental and emotional tools to help manage chronic pain and the stress that makes it worse. You can combine medical treatment with other treatments, such as counseling. This can increase your chances of success.
Common treatments include:
Alternative pain treatments for chronic pelvic pain aren't well studied. But they may help you to manage stress and learn ways to deal with pain.
Acupuncture and transcutaneous electrical nerve stimulation (TENS) have shown some success in relieving painful menstrual periods. Acupuncture and TENS have also been used as a treatment for nonmenstrual chronic pelvic pain, but this hasn't yet been well studied.
There are other low-risk alternative treatments that many people use to help manage pain. They include:
Chronic pelvic pain may be caused by problems in the female reproductive system. These include endometriosis, adenomyosis, and uterine fibroids. Other causes include scar tissue in the pelvic area after an infection or surgery, urinary or bowel diseases, and problems with the muscles, joints, and ligaments in the pelvis, lower back, or hips.
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.
Watch closely for changes in your health, and be sure to contact your doctor if:
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