Treating Women's Pelvic Pain

Common Treatments for Chronic Women's Pelvic Pain

Woman suffering from back pain.
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Treating women’s pelvic pain can be tricky. This is partly because women’s pelvic pain is often difficult to diagnose. Because there are so many conditions that can cause a woman’s pelvic pain, and because the treatments for each are so varied, finding the treatment that works for you may take time, as well as some trial and error.

If you are a woman, and you suffer from chronic pelvic pain, here are some of the types of treatments you can expect.

Hormone Therapy for Women's Pelvic Pain

For women’s pelvic pain conditions such as endometriosis or uterine fibroids, which are caused by abnormal tissue growth in and around the reproductive organs, hormonal treatments can often provide relief. Some examples include:

  • Birth control pills, which can regulate (or stop, depending on how they are taken) the menstrual flow. This can help ease the pain associated with endometriosis, however, this treatment is generally only effective as long as the pills are taken.
  • Progesterone and progestin, which work like birth control pills to reduce or stop the menstrual flow. They also suppress estrogen, which can help prevent uterine fibroids from growing in some women. However, they are not always effective at controlling fibroid growth.
  • GnRH agonists, or gonadotropin-releasing hormone agonists, temporarily send the body into a menopausal state which can help control endometriosis symptoms. They can also help shrink fibroids by blocking estrogen, and are often used pre-operatively for this purpose. GnRH agonists are generally used short-term.
  • Other hormones, such as antiprogestins and selective estrogen receptor modulators, may also be used to help shrink uterine fibroids, though no evidence suggests yet they are more effective than other treatment approaches. Danocrine has also been used for both uterine fibroid and to control endometriosis, however, its side effects (acne, weight gain, headaches, fatigue and voice changes) tend to outweigh its potential benefits.

    Antibiotics for Women's Pelvic Pain

    For women whose pelvic pain is caused by PID, or pelvic inflammatory disease, antibiotics may be the answer. Antibiotics for PID may be administered orally or by injection, and are often given in pairs. This is because time is key in treating PID before it leads to scar tissue formation. After this, surgery may be the only other option.

    Over-the-Counter or Prescription Painkillers for Women's Pelvic Pain

    Painkillers can often control the symptoms of mild to moderate women’s pelvic pain. Painkillers may be prescribed for conditions such as vulvodynia, uterine fibroids, endometriosis and pelvic joint instability. Some of the commonly suggested or prescribed painkillers for women’s pelvic pain include:

    • NSAIDs and acetaminophen may be used to control pain associated with pelvic joint instability, uterine fibroids, and endometriosis. They are often only effective if pain is mild. NSAIDs should not be taken by pregnant women.
    • Antidepressants and anticonvulsants can help control pain associated with vulvodynia, which is notoriously difficult to treat, due to their pain blocking mechanisms.
    • Opioids may be used to control pain symptoms in cases of severe pelvic pain, such as endometriosis that has not responded well to other treatment approaches, or vulvodynia.

    Painkillers are generally not the mainstay in treating women’s chronic pelvic pain, as they tend to control the symptoms instead of the actual problem. Because of this, painkillers are often combined with other treatment approaches.

    Physical Therapy for Women's Pelvic Pain

    Some women’s pelvic pain conditions, such as vulvodynia and pelvic joint instability, may be improved with physical therapy. Physical therapists who specialize in women’s health can provide the following:

    • Pelvic floor and core strengthening
    • Training on body mechanics to prevent further exacerbations of pain
    • Supportive taping or strapping
    • TENS

    Surgery for Women's Pelvic Pain

    In some cases of women’s pelvic pain, surgery may be necessary to treat the disorder’s cause. Women who have uterine fibroids and endometriosis that have not responded to hormonal therapy may require surgery. Women with PID for whom antibiotic therapy did not work may also require surgical intervention. Types of surgery commonly used to treat women’s pelvic pain include:

    • Laparoscopy. Often performed as an outpatient procedure for endometriosis, a laparoscopy involves making small incisions in the abdomen, and using small instruments to remove sections of endometrial and/or scar tissue from PID.
    • Myomectomy. A myomectomy involves removing tissue from the uterus while leaving the remainder intact. It may be used for the treatment of uterine fibroids, however in some cases, fibroids may return after surgery.
    • Hysterectomy. A hysterectomy involves removing part or all of the uterus, and may include removal of the ovaries and other tissues around the uterus. A hysterectomy may be used for advanced cases of endometriosis or uterine fibroids.
    • Pelvic nerve blocks, ablation or removal. In some cases of severe pain that does not respond to other treatments, blocking or destruction of pelvic nerves may help control pain symptoms. This treatment may work for vulvodynia or endometriosis.

    What Kind of Treatment Will I Have for My Pelvic Pain?

    Because there are so many potential causes of women’s pelvic pain, finding the right treatment can be difficult. In general, physicians will start with the least invasive treatments, such as medications, and progress as needed until the symptoms are under control.

    Treatments may be used on their own, or in different combinations. Based on your diagnosis, your doctor will tailor a specific treatment for you.


    Centers for Disease Control and Prevention. Pelvic Inflammatory Disease - CDC Fact Sheet. Accessed 8/26/09.

    The Merck Manuals Online Medical Library. Uterine Fibroids. Accessed 8/26/09.

    Mitchell DA, Esler DM. Pelvic Instability - Painful Pelvic Girdle in Pregnancy. Australian Family Physician. 2009 Jun;38(6):409-10

    National Institute of Child Health and Human Development. What is Endometriosis? Accessed 8/26/09.

    National Vulvodynia Association. About Vulvodynia: Treatment. Accessed 8/26/09.

    Stones W, Cheong YC, Howard FM. Interventions for Treating Chronic Pelvic Pain in Women. Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No.: CD000387. DOI: 10.1002/14651858.CD000387.

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