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Chronic Pelvic Pain

There are many conditions that can cause pelvic pain. If you’re experiencing pain and discomfort you should talk to your healthcare provider to determine the cause to identify an appropriate treatment plan. Let’s look at some of the common causes of chronic pelvic pain. 

What is Pelvic Pain?

According to Johns Hopkins Medicine, “pelvic pain is a common problem among women. Its nature and intensity may fluctuate, and its cause is often unclear. In some cases, no disease is evident. Pelvic pain can be categorized as either acute, meaning the pain is sudden and severe, or chronic, meaning the pain either comes and goes or is constant, lasting for a period of months or longer.” Chronic pelvic pain is typically categorized as when your pain lasts longer than six months and has shown no improvement.

What Are Some Common Causes of Chronic Pelvic Pain?

Menstrual Cramps/ Dysmenorrhea

Menstrual cramps are very common, and women experience a range of pain associated with menstruation. Some women have mild discomfort, while others experience pain severe enough to interfere with daily activities. This pain may occur before and during your period. These cramps can be normal, but if you’re suffering from severe pain, find your symptoms interfering with your regular life or they are progressively getting worse, it’s time to review your symptoms with your healthcare provider.

Endometriosis

Endometriosis (often called “endo”) is a painful disorder where the tissue that lines your uterus grows outside of the uterus. This tissue functions just like uterine tissue — becoming thick, breaking down and bleeding each month. However, if the tissue is located outside of the uterus, the tissue and blood has no way to exit the body. This build-up can irritate other areas inside the body, and the tissue may form into scar tissue and adhesions. Endometriosis can cause anything from mild to severe pain, and may also interfere with fertility. Pain is not necessarily an indicator of the severity of your disorder. An early endo diagnosis can help to manage your symptoms more effectively. There are multiple treatment methods, including medication, hormone therapy, surgery or fertility treatments if you’re struggling to become pregnant.

Cancer

Pelvic pain can be associated with ovarian and uterine cancer, but not all cancers cause pelvic pain. The most common symptom of gynecological cancers is abnormal vaginal bleeding or discharge. The Centers for Disease Control and Prevention (CDC) offers a gynecological cancer symptoms diary you can use to track symptoms if you are experiencing abnormal signs and believe you are at high risk for cancer. Keeping up on your annual exams and cancer checks as recommended by your healthcare provider is the best way to prevent cancer or to catch it early when treatment is most successful. 

Uterine Fibroids

A uterine fibroid is a noncancerous growth. These growths vary in size and location and may change with pregnancy or menopause. However, it is possible for fibroids to grow large and cause discomfort or even pain. If your doctor finds fibroids during an exam, it doesn’t necessarily predict that you will experience problems. In fact, most fibroids do not cause symptoms and do not require treatment.

Endometrial Polyps

Much like uterine fibroids, endometrial polyps are an overgrowth of cells. These polyps typically attach to the inner wall of the uterus. Most polyps are benign but some may be cancerous. Treatment for endometrial polyps may include monitoring and tracking the growth of the polyp, medication to control symptoms or surgical removal of the polyp. These polyps may interfere with fertility, so removal could be recommended for someone struggling to become pregnant.

Scar Tissue

Scar tissue can form in the uterus due to a variety reasons, including endometriosis, cesarean section, a prior miscarriage, or other factors. Scar tissue may decrease fertility or cause cyclical pelvic pain when menstrual blood becomes trapped in the uterus. Removal of the scar tissue may remedy these problems.

What Will My Doctor Want to Know?

Any information you can share about your pain can be helpful in diagnosing your condition. While some conditions are easy to determine with a test, others are diagnosed by ruling out other possibilities. When pain and discomfort occur, consider writing it down in a small journal or making a note on an app. Pay attention to these types of questions:

  • Where in your body does the pain occur, and what does it feel like? 
  • How long does the pain last? 
  • How did it begin — were you participating in an activity when it began? 
  • Is the pain related to your menstrual cycle, going to the bathroom or sexual activity? 

By tracking your pain symptoms you may be able to uncover patterns that will help your healthcare provider to make a diagnosis. 

 

Woman lying on the couch, hands across stomach, looking pained