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When a woman experiences pelvic pain for six months or longer, it is considered chronic pelvic pain. The pain can have many different characteristics such as intermittent or steady, dull or severe, cramping or even a sense of pressure in the abdomen.
A woman may experience pelvic pain or discomfort during intercourse, when having a bowel movement, or when sitting down. It can be cyclical and intensify near the time of menstruation.
The location of the pain can include:
Vulvar pain, which is pain felt on the surface (outside) of the vagina at the vulva, or labia
Vaginal pain, which is felt within the vagina
Deep pain, which can occur in the lower back, pelvis, uterus and bladder.
Common causes of pelvic pain
Common causes of intercourse pain could be linked to:
Poor communication between partners
Physical conditions (such as pregnancy)
Medication use (birth control pills and mood stabilizers)
Illness (vaginal infections, endometriosis or vulvadynia)
History of sexual assault
Tension in pelvic floor muscles
Pain that starts deep inside (near the cervix) could be a warning sign of an internal problem that might include:
Pelvic Inflammatory Disease
Problems with the uterus
Irritable bowel syndrome
Diagnosing pelvic pain
In order to determine the appropriate treatment, it is critical to identify the underlying cause of a woman’s pelvic pain.
Your physician may recommend certain tests and examinations to diagnose the cause of pelvic pain, including:
Pelvic examination to look for signs of infection, abnormal growths or tense pelvic floor muscles
Cell samples, or cultures, from your cervix or vagina to check for infection, including sexually transmitted diseases
Laparoscopy to look for abnormal tissues or signs of infection in your pelvis, particularly if endometriosis is suspected or to look for signs of chronic pelvic inflammatory disease
Ultrasound, abdominal x-rays or other imaging studies to help detect abnormal structures or growths in the pelvis and uterine cavity
Treatments for pelvic pain
UW Health obstetricians and gynecologists are experienced in diagnosing and treating pelvic-pain disorders.
Once the underlying cause of the pain has been identified, there are several possible treatment options, including:
Pain relievers, including over-the-counter or prescription depending on the intensity of the pain
Hormone treatments, such as birth control pills or other hormonal medications
Antibiotics if the pain is the result of an infection
Mindfulness-based stress reduction or other stress management techniques
Trigger point injections
Nerve separation (ablation)
You might need to try different combinations of treatment options to find a satisfactory level of pain relief.