Chronic Pelvic Pain in Fibromyalgia & Chronic Fatigue Syndrome

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Chronic pelvic pain is common in people with fibromyalgia (FMS) and chronic fatigue syndrome (ME/CFS). We can have pain just about anywhere, so this one may be hard to spot. It pays to be on alert for different sources of pain, though. Then, you can have them diagnosed and treated, which can improve your life and overall health.

A key thing to remember is that pain from FMS and ME/CFS don't generally sit in the same place all the time.

Also, in many cases, it comes and goes. If you consistently have pain in a certain area, or pain that's tied to sex, your menstrual cycle, or some other factor that you can identify, pay special attention to it and bring it up to your doctor. Be sure to note differences you've found between it and your "normal" pains.

Chronic pelvic pain isn't just one thing with one cause—it's actually an umbrella term for any condition that causes persistent pain in and around the pelvic cavity, which is the lower part of your abdomen. When you have cramping from menstruation or diarrhea, for example, that's in your pelvic cavity.

The Basics of Chronic Pelvic Pain

A lot of conditions can cause chronic pelvic pain. Research links only some of them to FMS and ME/CFS (denoted with a * below.) Your doctor may want to start with those but may also explore some of the others depending on your specific symptoms.

Several conditions that can cause chronic pelvic pain are gender-specific. Causes specific to women include:

Some common causes specific to men are:

Causes that are not necessarily related to gender include:

Symptoms, treatments and diagnostic procedures vary based on the specific condition. The sheer number of possibilities can make it tough to figure out, so it may take a long time for you to get a diagnosis. That's really not fun when you're miserable, but keep in mind that the right answer and, especially, the right treatment are what you're after.

Why Is Chronic Pelvic Pain Linked to FMS & ME/CFS?

While we don't fully understand the relationships between these conditions, some researchers now believe FMS, ME/CFS, and many causes of chronic pelvic pain are all in a "family" of illnesses called central sensitivity syndromes (CSS).

All CSS involves an underlying mechanism called central sensitization, which involves abnormalities in your brain and nerves that make you extremely sensitive to a variety of things, such as pain, temperature, and sound.

Chronic Pelvic Pain in FMS & ME/CFS

Chronic pelvic pain, like any pain source, may cause symptoms of FMS or ME/CFS to intensify.

Proper diagnosis and treatment of overlapping conditions is an important part of quieting all your symptoms and improving your life.

Because some symptoms are common to multiple CSS, you may get double duty out of certain treatments, such as pain medications (NSAIDs, opiates) and SSRI/SNRI antidepressants.

If you believe you have chronic pelvic pain, talk to your doctor to get the diagnostic process started.


Mayer TG, et al. Pain practice. 2012 Apr;12(4):276-85. The development and psychometric validation of the central sensitization inventory.

The Merck Manuals Online Medical Library. Pelvic Pain. Accessed January 2013. Pelvic Pain

Rodriguez MA, et al. Journal of urology. Jan;189(1 Suppl): S66-74. Evidence for overlap between urological and nonurological unexplained clinical conditions.

Rodriguez MA, et al. Journal of urology. 2009 Nov;182(5):2123-31. Evidence for overlap between urological and nonurological unexplained clinical conditions.

Smith HS, Harris R, Clauw D. Pain physician. 2011 Mar-Apr;14(2): E217-45. Fibromyalgia: an afferent processing disorder leading to a complex pain generalized syndrome.

U.S. Department of Health & Human Services. National Guideline Clearinghouse. Chronic Pelvic Pain. Accessed January 2013.