Chronic Female Pelvic Pain - Cause
If you have pelvic pain, your health professional will consider a broad range of possible causes. Female pelvic pain is typically caused by a medical condition involving the reproductive organs, muscles of the abdominal wall, urinary tract, or lower gastrointestinal tract. Some causes are always short-term (acute), and others can become long-lasting (chronic) unless successfully treated.
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. For this reason, some women have chronic female pelvic pain with no known cause, even after a lot of testing. This does not mean, however, that there isn't a cause behind the pain nor that there is no possible treatment.1
Chronic pain with no diagnosable cause can occur in any part of the body. Long after a disease or injury has healed, nerves can continue firing pain signals (neuropathic pain ). This is thought to be caused by an overloading of the nervous system by extreme or long-lasting pain. It also helps explain why it's fairly common for chronic pelvic pain to have no obvious cause.
Conditions that can cause acute pelvic pain include:
- Normal ovulation, which can cause brief ovary pain, or "mittelschmerz." This pain is cyclic, meaning that it happens once during each normal menstrual cycle.
- Ectopic pregnancy, which requires emergency treatment. For more information, see the topic Ectopic Pregnancy.
- Kidney stones, which can become chronic. For more information, see the topic Kidney Stones.
- Appendicitis, which requires immediate medical care. For more information, see the topic Appendicitis.
- Functional ovarian cysts, which can become chronic. For more information, see the topic Functional Ovarian Cysts.
- Urinary tract infection. For more information, see the topic Urinary Tract Infections in Teens and Adults.
- Pelvic inflammatory disease (PID) or tubo-ovarian abscess, which requires medical treatment. For more information, see the topic Pelvic Inflammatory Disease.
- Sexually transmitted diseases, which occasionally become chronic. For more information, see the topic Exposure to Sexually Transmitted Diseases.
Conditions that can cause chronic pelvic pain include:
- Endometriosis, the growth of uterine lining (endometrial) tissue outside of the uterus, which often causes cyclic pain and bleeding. For more information, see the topic Endometriosis.
- Adenomyosis, the growth of endometrial tissue into the uterine muscle, which can cause cyclic pain and bleeding.
- Noncancerous (benign) tumors of the uterus, such
as:
- Uterine fibroids. For more information, see the topic Uterine Fibroids.
- Endometrial polyps.
- Scar tissue (adhesions) in the abdomen and pelvis, typically caused by pelvic inflammatory disease, radiation treatment of the pelvis, or pelvic or abdominal surgery. For more information, see the topic Pelvic Inflammatory Disease.
- Bowel problems, such as irritable bowel syndrome. For more information, see the topics Abdominal Pain, Age 12 and Older and Irritable Bowel Syndrome.
- Physical or sexual abuse in the recent or distant past. (Though poorly understood, combined emotional and physical trauma are thought to cause chronic pain or make it worse.1) For more information, see the topics Domestic Violence and Child Abuse and Neglect.
- Urinary tract problems, such as bladder inflammation (chronic interstitial cystitis).
- Pelvic organ cancers. For more information, see the topics Endometrial (Uterine) Cancer, Ovarian Cancer, and Cervical Cancer.
- Structural problems with the uterus.
- Muscle spasm or pain in the lower abdominal wall muscles ("trigger points"). This is sometimes linked to past surgery in that area.
WebMD Medical Reference from Healthwise
Chronic Female Pelvic Pain Topics
ENABLEX is a prescription medicine used in adults to treat the following symptoms due to a condition called overactive bladder:
- · having a strong need to go to the bathroom right away (also called "urgency")
- · leaks or wetting accidents (also called "urinary incontinence")
- · having to go to the bathroom too often (also called "urinary frequency")
IMPORTANT SAFETY INFORMATION
You should not take once-daily ENABLEX if you have certain types of stomach problems, glaucoma, or have trouble emptying your bladder. Side effects of ENBLEX include blurred vision, and more commonly dry mouth, constipation, indigestion, and abdominal pain. Use caution when doing certain activities until you know how ENBALEX affects you.
VIVELLE-DOT (estradiol transdermal system) IS AVAILABLE BY PRESCRPTION ONLY.
INDICATION
Vivelle-Dot is used after menopause to: reduce moderate to severe hot flashes; treat moderate to severe dryness, itching and burning in or around the vagina; help reduce your chances of getting osteoporosis (thin weak bones); and treat certain conditions in which a young woman's ovaries do not produce enough estrogens naturally. Vivelle-Dot 0.025 mg/day is only used to prevent osteoporosis from menopause. If you use Vivelle-Dot only to treat your dryness, itching, and burning in and around your vagina or if you use Vivelle-Dot only to prevent osteoporosis from menopause, talk with your healthcare professional about whether a different treatment or medicine without estrogens might be better for you.
IMPORTANT SAFETY INFORMATION
Estrogens increase the chances of getting cancer of the uterus (womb). Report any unusual vaginal bleeding right away while you are taking estrogens. Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb).
Do not use estrogens with or without progestins to prevent heart disease, heart attacks, or strokes. Using estrogens with or without progestins may increase your chances of getting heart attacks, strokes, breast cancer, and blood clots. Using estrogens with progestins may increase your risk of dementia (decline in memory and thinking skills).
Vivelle-Dot should not be used if you have unusual vaginal bleeding; currently have or have had certain cancers, including cancer of the breast or uterus; had a stroke or heart attack in the recent past (for example, in the past year); currently have or have had blood clots; currently have or have had liver problems; or think you may be, or know that you are, pregnant.
The most common side effects that may occur with Vivelle-Dot are headache, breast tenderness, and back pain.
You and your healthcare professional should talk regularly about whether you still need treatment with Vivelle-Dot.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Please see Full Prescribing Information for Vivelle-Dot.


