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Dr. Weavil: Female Chronic Pelvic Pain

Many women have experienced pain in the pelvic area, the area below the belly button and in between the hips. Any pain in the pelvic area that lasts for greater than six months is considered chronic. Approximately 20% of women ages 18 to 50 are affected by chronic pelvic pain. The pain can be cyclic in nature, connected to the menstrual cycle, or a daily occurrence. Regardless, it can adversely affect all aspects of a woman’s life, including physical activity, romantic relationships, work, school, and sleep habits.

A variety of conditions cause chronic pelvic pain. In many cases, chronic pelvic pain is due to problems with the reproductive organs, but can also be caused by problems with the urinary, digestive, or the muscular and skeletal (musculoskeletal) system.

The most common cause of chronic pelvic pain is endometriosis. Endometriosis is a non-cancerous, but oftentimes painful, disease where cells from the lining of the uterus implant on the outside of the pelvic organs. Just as cells from the lining of the uterus bleed and shed during a woman’s period, the endometriosis cells also bleed and shed in the pelvis at that time, causing pain. Often the pain is cyclic in nature, only occurring slightly before and during menstruation. But if left undiagnosed or untreated, endometriosis can lead to constant pain the entire month. Endometriosis treatment depends on the severity of symptoms and could include hormonal medication, surgery to remove the endometriosis, or a total hysterectomy (removal of uterus and cervix).

Other common causes include chronic pelvic infections, persistent ovarian cysts, and uterine fibroids. Often the most difficult aspect of dealing with chronic pelvic pain is finding its cause. If you experience pain in the lower abdomen or pelvic area, keeping a “pain journal” can help you and your doctor determine the cause of pelvic pain. A helpful “pain journal” tracks your pain and could include:

Timing of pain. What time of day does the pain occur? Does it occur during the menstrual cycle? Does it occur before, during, or after the following activities: eating, urination, bowel movements, physical activity, intercourse, or sleep?

Describe the pain. Is the pain sharp or dull? Is it constant or does it come in waves? Does the pain radiate to other parts of the body? Is it always in the same place? What makes it better and what makes it worse?

Medical and surgical treatment options are available. If pelvic pain lasts longer than six months, seek help from a physician who specializes in women’s health.

To schedule an appointment with Dr. Weavil, call (530) 543-5711.