What is female pelvic pain, and when is it considered chronic?
Pelvic pain is pain that affects one or more areas of the lower abdomen and pelvis Depending on its cause, the pain may come and go without warning or with each menstrual cycle, or it may be constant. Pelvic pain can range from mild and troubling to severe enough to interfere with physical or sexual activities, daily responsibilities, family relationships, and your general sense of well-being.
Chronic pelvic pain is generally used to describe pelvic pain that has lasted for at least 6 months. Beyond this, there is no single, widely accepted definition of chronic pelvic pain. Some health professionals include pain that is caused by a known medical problem, while others only diagnose chronic pelvic pain when there is no apparent cause or when a cause has been treated, yet the pain persists.
Chronic female pelvic pain can be a difficult-to-solve medical mystery. Experts have yet to understand all possible causes of pelvic pain, particularly when it has become chronic. When the pain itself is the medical condition, chronic pain treatment becomes necessary. This is different from medical treatment of a known painful health problem, such as endometriosis.
What are common causes of chronic female pelvic pain?
Chronic pelvic pain is most commonly caused by endometriosis, adenomyosis, uterine fibroids, or scarring (adhesions) in the abdomen or pelvis following a pelvic infection or surgery. Some women have pelvic pain linked to diseases of the urinary tract or bowel, including irritable bowel syndrome.
Sometimes, women have chronic pelvic pain that has no clear cause after thorough testing. At other times, once a painful condition is treated, the affected nerves don't stop transmitting pain signals. This is called neuropathic pain, a type of chronic pain.
About half of women with chronic pelvic pain report a history of sexual or physical abuse.1 Although this is not well understood, past or current abuse is strongly linked to chronic pelvic pain.
What are common symptoms?
Because there are many problems that can affect the pelvic area, symptoms can vary depending on the underlying cause. Symptoms can include:
Mild to severe pain in the lower abdomen or pelvis.
Vague to sharp pain in the lower abdomen or pelvis.
Painful periods.
Pain during sexual intercourse.
Painful urination.
Pain during bowel movements.
Chronic pain can lead to depression. Common signs of depression include sleep problems, appetite changes, feeling empty and sad, and slowed body movements and reactions. If you have depression symptoms, see your health professional. For the best chance of recovery from pain, depression must be treated along with any known physical cause(s) of pain.
Most women are healthy during pregnancy and do not have serious health concerns. You may have minor physical symptoms throughout your pregnancy that are considered normal pregnancy changes. It is important for you to be aware of symptoms that might indicate a more serious problem. Work in partnership with your health professional and communicate your concerns during your pregnancy so that your health problems can be evaluated quickly.
Many minor problems related to your pregnancy can be managed at home. Home treatment measures are usually all that is needed to relieve mild morning sickness or discomfort from heartburn or constipation. If you develop a problem and your health professional has given you specific instructions to follow during your pregnancy, be sure to follow those instructions.
While most problems that occur during pregnancy are minor, you may develop more serious symptoms related to:
· Miscarriage. Symptoms may include:
o Vaginal bleeding.
o Tissue that passes through the vagina.
· Premature birth. Symptoms may include:
o Abnormal vaginal discharge or fluid leaking from your vagina.
o Abdominal, pelvic, or back (flank) pain.
o Preterm labor, which occurs when contractions begin before the 37th week of pregnancy.
· Infection. Symptoms may include:
o Fever.
o Nausea and vomiting or diarrhea.
o Urinary problems, such as a urinary tract infection or inability to urinate.
· Changes in your blood pressure may indicate preeclampsia. This problem may cause:
o Abnormal swelling, such as swelling of your face, hands, or feet.
o A new or different headache.
o Vision problems.
o Pain in the upper right abdomen.
o Nausea and vomiting.
During the days and weeks after delivery (postpartum period) you can expect changes as your body returns to its nonpregnant condition. Like pregnancy changes, postpartum changes are different for every woman. Although most women do not have serious health problems during the postpartum period, you should see your health professional if you develop heavy vaginal bleeding or postpartum depression.
