Causes of Women's Pelvic Pain and Symptoms
There are several causes of women’s pelvic pain, and symptoms often differ by diagnosis. Here are the most common types of chronic pelvic pain in women.
- Vulvodynia. Vulvodynia causes pain in the vulva, or the external female genitals. This type of women’s pelvic pain may come and go, or may be constant. It is often described as burning or stinging pain. While the pain is usually located in and around the vulva, it does not always occur in the same spot each time.
- Endometriosis. Endometriosis occurs when the lining of the uterus grows outside of the uterus. The tissue may attach itself to the ovaries or fallopian tubes, and may even reach the bladder or the intestines. Unlike the lining of the uterus, endometrial tissue does not shed during the menstrual cycle. Endometriosis can cause pelvic pain that is often worse during the menstrual period or sex. Though it is a women’s pelvic pain condition, it can also cause abnormal bleeding and may lead to infertility.
- Uterine fibroids. Uterine fibroids are non-cancerous growths inside the walls of the uterus, and vary in size. Uterine fibroids can cause sharp pelvic pain or cramps, often worse before and during the menstrual period. This type of women’s pelvic pain may be more painful during sex, and may also be felt in the lower back.
- Pelvic joint instability. Sometimes after childbirth, the ligaments that stretch to allow a baby to pass though the pelvic joints become unstable. This can cause discomfort not only in the pelvis, but in the lower back as well.
Women are also prone to other causes of chronic pelvic pain that are not gender specific, including urinary disorders, irritable bowel syndrome (IBS), neuropathy (pelvic nerve pain) and pelvic inflammatory disease (PID), to name a few.
Treatment for women’s pelvic pain depends on the exact cause, and the pain’s severity. Mild chronic pelvic pain can be treated with acetaminophen or NSAIDs, either in prescription or over-the-counter strength. Other medical treatments include:
- Hormone therapy. Hormones such as birth control pills or progesterone may be used to treat women’s pelvic pain caused by endometriosis. Gonadatropin-releasing hormone (GnRH) agonists can be used to treat women’s pelvic pain caused by endometriosis or uterine fibroids.
- Surgery. Conditions such as endometriosis may require surgical interventions such as a laparoscopy or even a hysterectomy. Uterine fibroids may also require a hysterectomy, though they can often be removed through a less intrusive procedure called a myomectomy, which leaves healthy portions of the uterus in place.
- Physical therapy. Along with pharmaceuticals, physical therapy is one of the few ways to manage the symptoms of vulvodynia. Physical therapy can also offer relief from post-childbirth women’s pelvic pain. Physical therapy treatments may be combined with pain medications.
Complementary treatments may also be effective at treating some women’s pelvic pain. While the literature on complementary treatments for pelvic pain treatment is somewhat limited, some research shows that writing therapy and the use of magnets can be beneficial, at least in the short-term. Other approaches include:
- Guided imagery
Prognosis for Women's Pelvic Pain
Like many chronic pain diagnoses, the prognosis of women’s pelvic pain can be hard to predict. Some diagnoses, such as vulvodynia, are a bit of a mystery and are therefore harder to treat. Some conditions, such as pelvic pain caused by uterine fibroids, may resolve after surgery. Unfortunately, however, many women continue to suffer from chronic pelvic pain even after pain management interventions.
If you are not getting relief from your chronic pelvic pain, consider looking into some of the complementary therapies listed above. Talk to your doctor about other approaches to your treatment. Like most chronic pain diagnoses, treating women’s pelvic pain can take some time.
National Institute of Child Health and Human Development. Facts About Uterine Fibroids. Accessed 7/21/09. http://www.nichd.nih.gov/publications/pubs/fibroids/sub1.cfm#treatments
National Institute of Child Health and Human Development. Pelvic Pain. Accessed 7/21/09. http://www.nichd.nih.gov/health/topics/Pelvic_Pain.cfm
National Institute of Child Health and Human Development. What is Endometriosis? Accessed 7/21/09. http://www.nichd.nih.gov/publications/pubs/endometriosis/sub2.cfm#surgical
National Pain Foundation. Pelvic Pain: Causes. Accessed 7/21/09. http://www.nationalpainfoundation.org/articles/717/causes
National Pain Foundation. Pelvic Pain: Complementary Techniques. Accessed 7/21/09. http://www.nationalpainfoundation.org/articles/280/complementary-techniques
Stones W, Cheong YC, Howard FM. Interventions for Treating Chronic Pelvic Pain in Women. Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No.: CD000387. DOI: 10.1002/14651858.CD000387.