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Pelvic Pain

"Pelvic pain" describes pain that occurs mostly or only in the region below a woman's belly button. This region includes the lower stomach, lower back, bottom, and genital area. Pelvic pain is chronic if it lasts for more than 6 months and affects a woman's quality of life. This condition is a common reason why women seek medical care

About 15% of women of childbearing age in the U.S. report having pelvic pain that lasts at least 6 months. Among them, about 15% of employed women have pain that is severe enough to cause them to miss work

Symptoms of Pelvic Pain

The symptoms of pelvic pain vary from woman to woman. Pelvic pain can be severe enough that it interferes with normal activities, such as going to work, exercising, or having sex.

Women describe pelvic pain in many ways. Pelvic pain can be steady, or it can come and go. It can be a sharp and stabbing pain felt in a specific spot, or a dull pain that is spread out. Some women have pain that occurs only during their menstrual periods. Some women feel pain when they need to use the bathroom, and some feel pain when lifting something heavy. Some women have pain in the vulva (the external genitals), which is called vulvodynia, during sex or when inserting a tampon.

Causes of Pelvic Pain

Researchers do not know the exact causes of pelvic pain. Often, pelvic pain signals that there may be a problem with one of the organs in the pelvic area. This organ could be a reproductive organ, such as the uterus (also called the womb), or other organs like the intestine or the bladder. Pain also can be a symptom of an infection.

The extent of a woman's pelvic pain is not always the same as the extent of the related condition. For example, if a woman has a physical abnormality that is associated with the pain, the size of the abnormality may be small, but she may still experience a lot of pain.

The following health problems can cause or contribute to pelvic pain:

A woman may have more than one cause of pelvic pain at the same time. In some cases, a person with one chronic pain condition has an increased risk for other types of chronic pain.

Studies have found a good deal of overlap among pain conditions. For instance, a woman may have endometriosis, irritable bowel syndrome (IBS), and depression at the same time—each of which contributes to the overall pain she feels. Having more than one pain condition can complicate diagnosis and treatment. To be effective, treatment needs to address all the conditions that are contributing to a woman's pain.

Diagnosis of Pelvic Pain

To find out the cause of a woman's pain, her health care provider will:

The information the doctor gathers from the questions and physical exam will help the doctor decide whether additional tests or procedures are needed to help diagnose the cause of the pelvic pain. These tests or procedures may include:

Finding the cause of pelvic pain can be challenging and can take time. Some women must check with more than one doctor or with a specialist to get help for their pain. Sometimes, the cause of the pain is not found. But failure to locate the cause does not mean that the pain a woman feels is not real or that it cannot be treated. Understanding what triggers the pain also can be helpful.

Treatment of Pelvic Pain

Treatment depends on the cause of pelvic pain, how intense the pain is, and how often the pain occurs. No one treatment approach has been shown to be better than another in all cases.

Some treatment options include:

Finding a treatment that works can take time. Some women want to try alternative therapies to relieve their pain. Learning healthy ways to cope with pain is an important aspect of any treatment approach.

How can I describe my pain to my doctor?

The better you can describe your pain, the easier it may be for your doctor to find the cause of the pain and treat your pain. Information that is helpful to your doctor includes:

Keeping a pain diary or record of your pain is a good way to track your pain triggers as well as symptoms over time. Be as specific as possible. Some words that can help you describe the way your pain feels include:

Pelvic Pain and Pregnancy

Some pelvic conditions that are associated with pain also are associated with difficulty getting pregnant. These include:

Some treatments for pelvic pain also can affect a woman's ability to get pregnant. For example, hormonal birth control commonly is used to treat endometriosis. Hysterectomy, which is surgery to remove a woman's uterus, may be an option for women who are not helped by other treatments, but it makes pregnancy impossible. However, a woman may still be able to become a mother through other means, such as a surrogate carrier.

Reference: National Institutes of Child Health and Human Development