Chronic pelvic pain refers to pain in the region between your hips, below your bellybutton. In order to be considered chronic, the pain must last for at least six months or longer. Intensity can vary from being extreme enough to interfere with normal activities, to being relatively mild. The pain may come and go, or be constant; it can be a sharp pain or a dull ache.

If you're a woman, you might feel a dull pain during your period. It could also happen during sex. Pelvic pain can be a sign that there is a problem with one of the organs in your pelvic area, such as the uterus, ovaries, fallopian tubes, cervix or vagina. It could also be a symptom of infection, or a problem with the urinary tract, lower intestines, rectum, muscle or bone. If you're a man, the cause is often a problem with the prostate.

Causes of Pelvic Pain

Acute pelvic pain is pain that starts over a short period of time anywhere from a few minutes to a few days. This type of pain is often a warning sign that something is wrong and should be evaluated promptly. Pelvic pain can be caused by an infection or inflammation. An infection doesn't have to affect the reproductive organs to cause pelvic pain.

Many organs live in the pelvis, including the uterus, ovaries, fallopian tubes. The bladder and intestine, and appendix also live next to the reproductive organs, and sensations from these organs can feel like pain from the uterus or ovaries. To further confuse things, pain from the kidney and pain from muscles and from the abdominal wall can also seem to come from the pelvis.

Some gynecologic disorders cause pain that is usually unrelated to menstrual cycles. Sudden, often severe pain can result from rupture of an ectopic pregnancy (see Abnormalities of Pregnancy: Ectopic Pregnancy), acute degeneration of a uterine fibroid (see Uterine Fibroids), adnexal torsion, or rupture or bleeding of ovarian cysts or masses.

Symptoms

In addition, you may have pain during intercourse, while having a bowel movement or even when you sit down. The pain may intensify after standing for long periods and may be relieved when you lie down. The pain may be so bad that you miss work, can't sleep and can't exercise. The pain may vary from mild to severe, from annoying to disabling.

Pelvic pain can have many different causes. For example, pain can be caused by a gynecologic condition such as endometriosis, uterine fibroids, ovarian cysts and pelvic adhesions. It also can be the result of an intestinal, urinary or muscular problem. Pelvic pain can even be a manifestation of stress or depression.

Treatment

Treatment of pelvic pain is complex in patients with multiple problems. It usually requires specific treatment and simultaneous psychological and physical therapy. A good relationship should be established between the physician and the patient. Treatment of chronic pelvic pain (CPP) must be tailored for the individual patient. The goals of treatment must be realistic. They should be focused toward restoration of normal function (minimal disability), better quality of life, and prevention of relapse of chronic symptoms.