Causes of Chronic Pelvic Pain Symptoms

Narrowing Down the Causes of Chronic Pelvic Pain

woman climbing stairs with pain
What are the symptoms and possible causes of chronic pelvic pain?. Science Photo Library/Getty Images

What are the symptoms of chronic pelvic pain? Why is it helpful to break these symptoms down by sex and by body region to get to the root of your problem?

What is Chronic Pelvic Pain

Chronic pelvic pain is defined as pelvic pain which has been occurring for at least six months. The pain may be continuous or intermittent. Chronic pelvic pain can be very frustrating and often has a significant impact on your quality of life.

Symptoms and Causes of Chronic Pelvic Pain

There are so many different causes of pelvic pain, that it can be hard to know where to begin when someone states they have pelvic pain. Yet by narrowing down the particular type of symptoms you have, and considering different categories of pelvic pain, it becomes easier to diagnose where your pain may be originating, and thus, how to treat it.

Keep in mind that many of the causes of chronic pelvic pain differ from those of acute pelvic pain, and much of the information available on pelvic pain is directed at the symptoms and causes of acute pelvic pain.

Chronic pelvic pain symptoms may result from women’s health issues, men’s health issues, nerve disorders, musculoskeletal disorders, digestive problems or even mental health issues. Here's a look at the most common chronic pelvic pain symptoms by category.

Chronic Pelvic Pain in Women

Chronic pelvic pain in women may be caused by by issues with the reproductive organs, pelvic joint instability, or abnormal growths in the uterus.

Therefore, female-specific chronic pelvic pain symptoms may manifest as any of the following:

  • Heavy and/or painful menstrual periods
  • Pain in the abdomen or lower back
  • Pain during intercourse
  • Burning or stinging of the vulva (vulvodynia)

Common causes of chronic pelvic pain specific to women include:

Chronic Pelvic Pain in Men

Chronic pelvic pain in men which is specific to men is often caused by prostatitis, a swelling of the prostate gland.

Prostatitis can cause any of the following chronic pelvic pain symptoms in men:

  • Difficulty with or painful urination
  • Discomfort at the base of the penis
  • Lower back discomfort
  • Discomfort around the anus or the testicles
  • Pain during ejaculation
  • Blood in the semen

Nerve Disorders

Chronic pelvic pain symptoms can be caused by nerve damage or dysfunction, and may occur in both men and women.

The pudendal nerve, ilio-inguinal nerve, ilio-hypogastric nerve and genito-femoral nerve are all located in the abdominal and pelvic region, and may be damaged after surgery, during childbirth or from neuropathy.

Chronic pelvic pain symptoms caused by nerve disorders may include any of the following:

  • Pain during intercourse
  • Pain during urination or bowel movements
  • Pain when sitting
  • Pain in the lower abdomen or back
  • Pain in the genitals

    Irritable Bowel Syndrome (IBS)

    Irritable bowel syndrome, or IBS, is one of the most common causes of chronic pelvic pain symptoms in both men and women.

    IBS can cause any of the following:

    • Cramps in the lower abdomen (usually on the left)
    • Problems with bowel function, including diarrhea, constipation and bloating
    • Pelvic pain that is worse after eating, and goes away after a bowel movement
    • Pain during intercourse
    • Painful menstrual periods
    • Abdominal pain that is worse during times of stress, anxiety or depression

    Urinary System Problems

    Urinary disorders such as interstitial cystitis (IC), bladder tumors or renal obstruction can cause any of the following chronic pelvic pain symptoms:

    • Pain as the bladder fills (goes away after urinating)
    • Pain during urination
    • Urinary urgency and/or frequency
    • Pain during intercourse
    • Pain in and around the pelvic area

    Chronic Pelvic Pain from Osteitis Pubis

    Osteitis pubis is the term for chronic swelling of the pubic bone, and can occur in both men and women who are physically active.

    Chronic pelvic pain symptoms from osteitis pubis may include the following:

    • Pain in the pubic area, often worse with activity
    • Pain when squeezing the legs together
    • Pain when climbing stairs or squatting

    Other Causes of Chronic Pelvic Pain

    There are many other possible causes of chronic pelvic pain with newer possible diagnoses, such as pelvic congestion syndrome, being added to the list all the time. At this point in time you may be very frustrated if nothing seems to fit with your symptoms. If it is any consolation, you are not alone. With time, however, your symptoms may become clearer, and it's not uncommon for symptoms to resolve on their own over time without ever having a clear diagnosis. (See the bottom of this article on being your own advocate.)

    Diagnosing Chronic Pelvic Pain

    Chronic pelvic pain symptoms vary not only by diagnosis but by individual, as well. If you have chronic pelvic pain, your symptoms may include many or only few of those listed above. This is what makes chronic pelvic pain so difficult to diagnose. If you think you might have chronic pelvic pain symptoms, talk to your doctor about undergoing medical testing.

    Some people find it helpful to keep a journal to further define and narrow down the origins of their pain. You may wish to give your pain a number each day, such as a one for very mild pain and a 10 for the worst pain you can imagine. In your journal you can list things which appear to increase or decrease your pain. It's not uncommon for journaling to reveal trends in your pain or possible causes which are not obvious at any single point in time.

    Being Your Own Advocate with Chronic Pelvic Pain

    When you are coping with a problem like chronic pelvic pain, it is more important than ever to be your own advocate in your care. Pain is something which is hard for another to appreciate, as there is not a lab test or an imaging study which can characterize it and give it a number.

    If you are not getting answers, keep asking questions. You may need to get a second opinion. Physicians, like everyone else, can become frustrated when there doesn't seem to be a concrete cause of pain. In time and with perseverance, the source of your pain may become clear, and with that, the treatment of the cause.

    Sources:

    Barbieri, R., Patient education: Chronic pelvic pain in women (Beyond the Basics). UpToDate. Updated 08/18/16.

    Bharucha, A., and T. Lee. Aorectal and Pelvic Pain. Mayo Clinic Proceedings. 2016. 9(10):1471-1486.

    van Rijckevorsel, D., de Vries, M., Schreuder, L., Wilder-Smith, O., and H. van Goor. Risk Factors for Chronic Postsurgical Abdominal and Pelvic Pain. Pain Management. 201. 5(2):107-16.

    Continue Reading