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Chronic Pelvic Pain
Chronic pelvic pain is pain in the lower abdomen or pelvis that lasts for six months or longer. It may be constant or come and go, and can range from mild to severe. For some people it is linked to their periods or sexual activity, while for others it is present most of the time.
Chronic pelvic pain is common and can affect quality of life, work, relationships, and emotional wellbeing.
It is often caused by more than one factor, and sometimes no single cause can be identified.
Chronic pelvic pain may be linked to:
Gynaecological conditions such as endometriosis, adenomyosis, ovarian cysts, or fibroids
Pelvic inflammatory disease or past infections
Bladder or bowel problems such as irritable bowel syndrome or interstitial cystitis
Musculoskeletal or nerve pain in the pelvic area
Previous surgery or scar tissue (adhesions)
Emotional and psychological factors such as stress, anxiety, or a history of trauma
Often, several of these factors interact to contribute to ongoing pain.
How is Chronic Pelvic Pain Diagnosed?
Assessment begins with a detailed history and examination. Your specialist will ask about the nature of the pain, its timing, and any related symptoms such as changes with your periods, bladder or bowel function, or sexual activity.
Investigations may include ultrasound, blood or urine tests, or sometimes MRI. In selected cases, a diagnostic laparoscopy (keyhole surgery) may be recommended to look for conditions such as endometriosis.
Your gynaecologist can assess for conditions affecting the reproductive organs and advise on specific treatments, including surgery if appropriate.
Treatment Options
There is no single treatment that works for everyone. Management is usually tailored to your needs and may combine medical, surgical, and supportive approaches.
Specialist care from a gynaecologist can play an important role in coordinating investigations, offering surgical options when indicated, and working closely with other professionals to provide holistic care.
Medications
Medical options may include pain relief, hormonal treatments such as the pill or hormonal IUD, or medicines that target nerve pain.
Surgical Options
Surgical options, such as laparoscopy to treat endometriosis or remove scar tissue, may be helpful for some people.
Supportive Treatments
Supportive treatments such as physiotherapy, pelvic floor exercises, counselling, or cognitive behavioural therapy are often part of managing long-term pain. In some cases, referral to a multidisciplinary pain clinic is recommended.
Find A Specialist
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Dr Kate van Harselaar
Gynaecologist
