Chronic Pelvic Pain in Women: What You Should Know

Chronic pelvic pain is relatively common and has multiple triggers. We'll show you the main ones and how to treat it.
Chronic Pelvic Pain in Women: What You Should Know
Diego Pereira

Reviewed and approved by el médico Diego Pereira.

Last update: 24 February, 2023

Researchers classify chronic pelvic pain in women as episodes of cyclical or noncyclical pain lasting at least 3 to 6 months, respectively. Its manifestation is very broad, although it usually includes dysmenorrhea (severe menstrual cramps), dyspareunia (pain during sexual intercourse), dysuria (painful urination) and dyschezia (constipation associated with pain). We’ll show you what scientists say about it.

Its actual prevalence isn’t known, although some estimates suggest that up to 24% of women worldwide suffer from it. Chronic pelvic pain is, therefore, relatively common, and poses serious problems for well-being. Although many cases have no definite cure, something can almost always be done to treat them. We focus on its causes and treatment options.

Causes of chronic pelvic pain in women

The causes of chronic pelvic pain are still a matter of debate. There’s no single catalyst for these episodes, and the exact reason for the pain can’t always be found.

According to the evidence, many women take up to two years to seek medical attention, so they deal with their symptoms for a while before seeking help. Of all the possible explanations for pain, we’ll leave you with the best known.

1. Endometriosis

According to researchers, between 71% and 87% of women with chronic pelvic pain have endometriosis. Endometriosis is a disorder characterized by the growth of endometrial tissue outside the uterus.

It does so mainly in the ovaries, fallopian tubes, and in the tissue that lines the pelvis. As experts warn, it can take years and even decades for it to be correctly diagnosed.

2. Pelvic inflammatory disease (PID)

Specialists have also linked these episodes to pelvic inflammatory disease. The exact mechanism is not known, but it is believed to arise as a consequence of scarring, tissue damage, and adhesions resulting from inflammation and infection.

PID is an infection of a woman’s reproductive organs, often as a result of STDs (chlamydia, gonorrhea and others) and other types of infections.

3. Adenomyosis

Indications for vaginal probiotics.
The diagnosis of adenomyosis isn’t always easy and fast, so it’s important to see a specialist when symptoms are detected.

Adenomyosis occurs when the tissue that lines the uterus (endometrium) develops into the muscular wall of the uterus. It is similar to endometriosis, so much so that it shares many of its symptoms.

There is evidence that adenomyosis may be to blame for chronic pelvic pain in women. This cause is more common in the later years of childbearing, and usually disappears after menopause.

4. Uterine fibroids

Finally, experts have found that many patients with uterine fibroids also develop noncyclic pelvic pain. Fibroids are noncancerous growths that develop in or around the uterus.

They are also known as uterine fibroids, and don’t always cause symptoms. When fibroids reach a certain size, complications arise, including pain.

Other possible causes of chronic pelvic pain in women are interstitial cystitis, urinary tract infections, pelvic congestion syndrome, irritable bowel syndrome, levator syndrome, pelvic support problems, vulvodynia, as a consequence of surgery, among others.

Apart from physiological catalysts, psychological ones must also be considered. Indeed, there is evidence that trauma and post-traumatic stress disorder can lead to chronic pelvic pain. In addition, cases have been found whose catalysts are depression and anxiety.

These are just two examples of how these episodes can be psychological in nature. It’s important to note that many cases remain idiopathic (no direct cause of them is found).

Treatment for chronic pelvic pain

Chronic pelvic pain has treatment.
While there are several general treatments for pain, it is important to determine the cause in order to best resolve it.

There are many conditions that explain chronic pelvic pain in women. Given the variety of catalysts, there’s no single treatment.

The first step is to launch a diagnostic process so that the exact trigger can be found. When you know what is causing the pain, you can choose a specific therapy to control it.

As the specialists warn, the objective of the treatment is to maximize the quality of life and well-being of the patient, with emphasis on involving him in self-control. It’s for this reason that many therapies focus on symptom management, which is done before a specific diagnosis is made. In this way, it’s possible to control pain and improve the patient’s general well-being.

This is done considering that it can take months and even years before finding the exact catalyst. In the process, psychological and physiological factors are ruled out, and even then it isn’t always possible to find its trigger.

Based on the specialist’s criteria, the use of antibiotics, analgesics, hormonal treatments, and antidepressants can be considered.

You can also opt for complementary therapies, such as physical therapy, psychotherapy, trigger point injections, acupuncture, meditation, yoga, and pain rehabilitation programs. Interest in neurostimulation has grown in recent years, so it’s a strategy to consider. The most serious cases can be addressed through surgery.

There are many options for treating these episodes, and those affected should be aware of them. The alternative is not to learn to live with the pain, but to find its cause and in the process try different methods that provide relief. If you think you have chronic pelvic pain, be sure to consult a specialist, or in any case consult a second opinion.

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