Pelvic pain in women Mamae papatoiake

You may have pain in your pelvis for many reasons. It usually comes from one of the organs in your pelvis such as your:

• bowel
• bladder
• uterus or ovaries.

Sometimes the pain can come from your:

• pelvic bones or joints
• muscles
• nerves
• blood vessels.

Sudden pelvic pain

Many things can cause sudden (acute) pelvic pain, such as:

• pelvic inflammatory disease
• appendicitis
• irritable bowel syndrome (IBS)
• sexually transmitted infections (STIs)
• a urinary tract infection (UTI)
• an ovarian cyst
• ovulation – when your ovaries release eggs once a month in the middle of your menstrual cycle, you can sometimes feel a sharp and sudden pain when the egg is released.

Chronic pelvic pain

Persistent (chronic) pelvic pain is pain that has lasted for 6 months or more. It does not include pregnancy-related pain or pain you only get when you have your period or have sex.

Chronic pelvic pain is often due to a combination of factors. It can be difficult to diagnose and often no cause can be found.

Possible causes include:

• endometriosis
• irritable bowel syndrome (IBS)
• an inflamed bladder (interstitial cystitis)
• pelvic inflammatory disease
• scarring from previous surgery (often called adhesions)
• tight or spasmed muscles
• trapped or damaged nerves in your pelvic area
• depression.

Your healthcare provider will ask you questions about the pain, including:

• where and when the pain happens
• how severe it is
• how long it lasts
• what makes it better or worse.

They will ask about your past medical history and about any other symptoms. They may:

• examine your tummy
• check your joints for tenderness
• do an internal (vaginal) exam.

Based on what is found during the initial assessment, your healthcare provider might do more tests including:

• a urine sample
• blood tests
• an ultrasound scan
• a pregnancy test (if you have not yet reached menopause).

If you have persistent pain, your healthcare provider may also ask you how it affects your mood, everyday activities, work and sleep. They may suggest you fill out:

• a pain diary — a written record to help you keep track of symptoms or activities associated with pain
• a pelvic pain questionnaire
• a period (menstrual) diary — you can also download a period tracker app.

Period tracking apps — Healthify

These will all help your healthcare provider understand more about your pain and how it affects you.

Sometimes your healthcare provider will not be able to find out what is causing your pain.

The treatment will depend on what is causing your pain.

Your healthcare provider may refer you to a specialist doctor (a gynaecologist) for further investigations and treatment. If you have not already filled out a pelvic pain questionnaire, they may ask you to do this before your appointment. This is so they can understand more about your pain and how it affects your life.

When the cause cannot be found

If doctors cannot find the cause of your persistent (chronic) pain, they may recommend:

• medication
• counselling
• physiotherapy
• lifestyle changes.

Lifestyle changes may include:

• eating well
• staying physically active
• maintaining good posture
• managing stress
• getting enough sleep
• not smoking.

The treatment will focus on finding ways for you to deal with the pain so it does not have such a big impact on your life.

Chronic pain

The video 'Understanding pain (what to do about it in less than five minutes)' explains some of things you can do. 

Understanding pain — YouTubeexternal link

You may choose to see a:

• private gynaecologist
• physiotherapist specialising in pelvic problems
• psychologist.

Persistent pelvic pain can be very difficult to live with. You may experience:

• depression or anxiety
• difficulty sleeping
• disruption to your daily routine
• problems in your relationships
• bladder or bowel problems.

If your pain is making life difficult, talk to your healthcare provider.