Chronic Pelvic Pain: The Possible Causes

Chronic pelvic pain is often equally debilitating and elusive: where is this discomfort coming from? How can we address it if we don't know the source?

Some research suggests one in seven American women of childbearing age experiences chronic pelvic pain. This perpetual discomfort can seriously damage a person’s quality of life, interfering with their ability to work, relax or socialize.

Learn how a urogynecologist or pelvic medicine specialist can help you identify the precise cause of this pain.

How Is Pelvic Pain Different from Other Pain?

Chronic pelvic pain is defined as localized discomfort in the lower abdomen. It differs from other pain (like regular menstrual cramps) in its duration; chronic pelvic pain persists for six months or longer.

Types of Pelvic Pain

However, chronic pelvic pain may not feel the same for everyone. The discomfort can be:

  • A sharp intermittent pain
  • A nonstop, dull ache or pressure
  • An ever-present sensation, whether you’re at rest or physically active
  • Brought on by specific activities, like urination, bowel movements or sexual intercourse

Potential Causes of Pelvic Pain

Given that there are many types of pelvic pain, there are also many potential causes. The discomfort can be linked to a woman’s gynecological, gastrointestinal, urological, musculoskeletal or neurological system — or even a combination of several.

Here’s a summary of some common conditions linked to chronic pelvic pain.

Gynecological Sources of Pelvic Pain

  • Ovarian cysts: These fluid-filled sacs that grow on or within the ovaries are normal. However, if they grow unusually large, twist or rupture, they can cause debilitating pain.
  • Uterine fibroids: Like cysts, these benign growths within the uterus are not inherently dangerous. However, large fibroids can cause pain or heavy, irregular bleeding.
  • Endometriosis: In this chronic condition, tissue similar to the uterine lining (endometrium) grows outside of the uterus. This frequently causes pelvic pain, hormonal imbalances, or fertility issues.
  • Pelvic adhesions: These are clumps of scar tissue (which may form due to infection, trauma from previous pelvic surgeries, or endometriosis-related growths) that restrict the movement of pelvic organs like the uterus or ovaries, resulting in pain.
  • Pelvic inflammatory disease (PID): This is an infection that creates perpetual inflammation of the pelvic organs, causing pain and swelling.

Gastrointestinal Sources of Pelvic Pain

  • Irritable bowel syndrome (IBS): This is a very common disorder marked by uncomfortable, unpredictable or otherwise distressing bowel movements (e.g. diarrhea or constipation). This malfunctioning of the gastrointestinal tract can cause pain and bloating.

Urological Sources of Pelvic Pain

  • Interstitial cystitis: Also called painful bladder syndrome, this is a chronic condition that results in bladder pain and frequent urination.
  • Urinary tract infections (UTIs): UTIs, especially recurring ones, can result in sharp sensations and inflammation in the pelvic region.

Neurological and Psychological Sources of Pelvic Pain

  • Nerve entrapment: In some cases, pelvic nerves can become entrapped, producing pain signals in the lower abdomen.
  • Depression or anxiety: Research shows depression, anxiety and other mood issues can manifest in physical pain, including in the pelvis.

How Is Pelvic Pain Diagnosed? What Will My Doctor Ask?

If constant pelvic pain is bothering you, it’s important to notify your primary care doctor. Oftentimes, from there, your doctor will loop in a pelvic medicine specialist or urogynecologist.

To track down the root cause, the urogynecologist may ask you a variety of questions, such as:

  • When did you start feeling this pain?
  • Can you describe what this pain feels like?
  • How severe is it? How frequent is it?
  • How does this pain impact your day-to-day activities?

The specialist may even ask you to keep a journal for a few weeks or months, recording each time you feel the pain and to what severity. This helps them narrow down the source. For example, if you consistently record pain several hours after each meal, they may realize the source is gastrointestinal/digestive rather than gynecological.

After gathering this background information, the specialist may order different tests and screenings, such as:

  • Ultrasound: Sound waves are used to examine internal structures, including gastrointestinal and gynecological organs.
  • Laparoscopy: A minor surgical procedure during which a minimally invasive surgeon inserts a thin telescope through a small incision. This allows them to look directly at your pelvic organs.
  • Cytoscopy: A test during which the inside of the urethra and bladder are analyzed.
  • Colonoscopy: A test during which a small, lighted instrument is used to analyze the inside of the large intestine.

Pelvic Pain Treatment in El Paso

No matter the source, there are treatment options available for chronic pelvic pain.

No one should have to live in constant discomfort. Connect with one of our pelvic medicine physicians to help track down and address the source of your pain.

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