Women and Pelvic Pain – What You Should Know

Sarah Fox, MD, FACOG

It might surprise you to know that for women, pelvic pain is as common as asthma. In fact, about 15 percent of American women experience it.

Pelvic pain is defined as pain located anywhere in the front or back of the body from the navel to the groin, which has been present for more than six months.

While it is common, due to the personal nature of the symptoms, women often will not talk about their pelvic pain. You should not feel embarrassed to talk to your health care provider about your concerns!

The causes

There are dozens of known causes of pelvic pain. Often, pain comes from the bowel, bladder and female organs. Pain may also be related to muscle or joint dysfunction in the pelvis. Finally, nerve pain is a common cause of pelvic pain. Often a woman will have several causes of pain, which can make it difficult to diagnose and manage the pain.

Is some pelvic pain normal?

Many women have cramps with their periods, pain with ovulation in the middle of the menstrual cycle, or mild pain that comes and goes. These are common and usually not serious. If your pain interferes with your ability to function then you should seek care. 

Is it dangerous?

While some women may experience severe pain, chronic pelvic pain is usually not associated with dangerous conditions. It is important, however, that you talk to your provider about it. A thorough history and examination should be performed to look for anything serious. Your provider may recommend x-ray studies or lab tests.

What should I do if I have chronic pelvic pain?

  • See your primary care provider or your gynecologist to be sure there is nothing serious causing your pain.
  • Try using a heating pad and over the counter pain relievers.
  • Track your pain using a tracking app or on a calendar. Track your daily pain scores, your periods, bowel and bladder function. You can bring this in for your provider to review.
  • Continue to keep active. As much as you can, keep up your regular activities including exercise. If you are not able to do your usual exercise, consider walking or stretching exercises.

How is pelvic pain treated?

There are several types of treatments that are commonly used:

  • hormonal medications to control painful menses or cyclic pain
  • physical therapy to help with muscle and joint pain
  • non-opioid pain medications
  • meditation and other pain management techniques
  • surgery

Each woman is unique. It’s important to find what teatment approach is right for you. You may need to try several different things to find a combination that works best for you.

Warning signs

While pelvic pain may come and go, there are some warning signs to watch for. If you experience these, contact your provider immediately:

  • temperature of 100.8 or higher
  • blood in the urine or stool
  • inability to eat
  • a sudden change in the type of pain you are experiencing

What about surgery?

Many women who have chronic pelvic pain may often think they should have a hysterectomy and be done with it. Surgery, however, doesn’t always help. Often pain will stay the same after surgery and sometimes there can be worsening pain if there is scar tissue, nerve injury or other surgical complication. It’s recommended that all non-surgical options are explored before surgery.

If a full work-up shows there is a good chance that the female organs are involved in your pelvic pain, a hysterectomy may be an option.

Can pain medications help?

Over the counter medications such as acetaminophen or ibuprofen may help with pelvic pain. You should not use opioid pain medications for chronic pelvic pain. While these medications may be effective for acute pain following surgery, long-term use of opioid medications is not recommended. Not only can opioids be addictive, but they could be problematic as your body adjusts to the medication and you get less of a benefit from it. Studies have shown that people using opioid pain medications have poorer quality of life and are less functional than those who do not take opioid pain medications. In addition, opioids cause impaired sexual function, weakened immune function, and decreased bowel function, and can also increase pain perception in the entire body.

Things to remember

  • Make sure you find a provider to partner with who understands pelvic pain and is a good listener. Your provider should recognize that your pain is real and that it is important. It may take a little while to reach your goals, but having a good health care partner is critical to achieving the best outcome for you.
  • Be patient and kind to yourself. Make sure that you are getting regular exercise, adequate sleep and eating a healthy diet. This is important in helping your body to heal. 
  • Continue to live your life. Don’t fall into the trap of putting things off until your pain gets better. Although you may need to alter some activities, you need to continue to enjoy your life as much as you can every day. Don’t put your life on hold!

If you are experiencing pelvic pain, our Pelvic Pain Program can help. 

Pelvic Pain Program »

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