• Introduction
• Causes of Chronic Pelvic Pain
• Diagnosis of Chronic Pelvic Pain
• These Tests may be Helpful for Treatments
• Treatments of Chronic Pelvic Pain

Introduction:

Chronic pelvic pain may be a steady pain or a pain that comes and goes, perhaps with a woman's menstrual cycle. The pain may be bad enough to interfere with normal daily activities. Pelvic pain that has lasted for at least 6 months is considered chronic.

Causes of Chronic Pelvic Pain:

If you have chronic pelvic pain, you may have a problem with something located in the pelvic area. However, your doctor will check for other possible sources for your pain. Pelvic pain during sexual intercourse, for example, may be a sign of a medical condition like endometriosis, irritable bowel syndrome or urethritis, or it may be related to past or present sexual abuse.

Chronic pelvic pain can be intermittent or constant. Intermittent chronic pelvic pain usually has a specific cause, while constant pelvic pain may be the result of more than one problem. A common example of chronic pelvic pain is dysmenorrhea or menstrual cramps. Other causes of chronic pelvic pain include endometriosis, adenomyosis, and ovulation pain. Sometimes an illness starts with intermittent pelvic pain that becomes constant over time, this is often a signal that the problem has become worse. A change in the intensity of pelvic pain can also be due to a woman's ability to cope with pain becoming lessened causing the pain to feel more severe even though the underlying cause has not worsened.

Women who have had surgery or serious illness such as PID, endometriosis, or severe infections sometimes experience chronic pelvic pain as a result of adhesions or scar tissue that forms during the healing process. Adhesions cause the surfaces of organs and structures inside the abdomen to bind to each other.

Fibroid tumors (a non-cancerous, benign growth from the muscle of the uterus) often have no symptoms; however when symptoms do appear they can include pelvic pain or pressure, as well as menstrual abnormalities.

Diagnosis of Chronic Pelvic Pain:

Your doctor will ask you questions about your past and present health, and about illness or health-related problems in your family. You may be asked to describe the kind of pain you have, where it is and how strong it is. Tell your doctor anything you can about what causes the pain to get better or worse.

1. Is the pain related to your menstrual cycle?
2. Is it related to bowel movements?
3. Does it hurt during urination or sexual activity?
4. Have you had an infection?
5. Have you had surgery in your pelvic area?

Your doctor may also want to perform some tests to help make the diagnosis.  

These Tests may be Helpful for Treatments:

A number of tests can help your doctor find the cause of your pain. Your history and physical exam will help him or her decide which, if any, tests to do. These may include blood tests, urologic tests or x-rays. In some cases, your doctor may need to perform minor surgery, such as laparoscopy (a procedure in which a thin lighted tube is inserted in the abdomen so the doctor can look at your pelvic organs).

Treatments of Chronic Pelvic Pain:

Treatment depends on your individual problem. Your doctor will help you determine which form of treatment is right for you. Some treatment options include:

• Stopping ovulation (release of eggs from the ovary) with birth control pills or Depo-Provera injections.
• Use of nonsteroidal anti-inflammatory pain relievers such as ibuprofen (one brand name: Motrin) or naproxen (brand name: Aleve).
• Relaxation exercises, biofeedback (treatment to control emotional states using electronic devices) and physical therapy.
• Abdominal trigger point injections. A trigger point is a tender area in the lower wall of the abdomen. Pressure that is put on this area causes pain. Injecting medicine into the trigger point can block this pain.
• Antibiotics.
• Psychological counseling. 
• Surgery is usually only an option if abnormalities in the pelvis are seen.  

Source Adapted and modified: http://familydoctor.org