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Causes and Symptoms of Chronic Pelvic Pain

Pelvic Inflammatory Disease

This is an infection of the uterus, fallopian tubes, or ovaries that causes them to become inflamed and infected. Most often, it is a sexually transmitted bacterial infection, like gonorrhea or chlamydia. These bacteria enter the uterus through the vagina and leave the fallopian tubes to infect surrounding organs like the ovaries.  Scars left by the infection may cause chronic pelvic pain; however, more commonly the pain is acute.

Symptoms you may have:

  • Vaginal discharge having an unusual color, texture, or odor
  • Abdominal or pelvic pain in a specific area or more widespread
  • Pain during sex
  • Irregular or missed periods
  • Menstrual cramps that are worse than usual
  • Frequent need to urinate
  • Pain when you urinate
  • Pain when you ovulate
  • It hurts when you press on certain areas of your pelvis
  • Lower back pain
  • Fatigue
  • Fever
  • Nausea

Pelvic Congestion Syndrome

Pelvic congestion is just like the varicose veins that some women have in their legs, but it affects the veins of the pelvis. Blood backs up in the veins, making them become enlarged and engorged. Pelvic congestion causes chronic pelvic pain in some women.

Symptoms you may have:

  • Pain starts 7-10 days before your period
  • Pelvic pain is worse when you sit or stand
  • Lying down relieves pelvic pain
  • Lower back pain
  • Aches in your legs
  • Pain during sex

Irritable Bowel Syndrome

Chronic pelvic pain sometimes isn't only due to problems with reproductive organs or the urinary tract; other organs in the pelvic area, if "diseased," can present as pelvic pain. Irritable bowel syndrome, an intestinal condition that often causes pain, may be the cause.

Symptoms you may have:

  • Diarrhea
  • Constipation
  • Incontinence
  • Flatulence
  • Bloating
  • Pain relieved by a bowel movement


Uterine Fibroids

Fibroids are noncancerous tumors that grow in, and on, the wall of the uterus. Not all women who have them notice symptoms, but for some, fibroids can be painful.

Symptoms you may have:

  • Heavy periods
  • Feeling pressure or fullness in your abdomen
  • Need to urinate frequently
  • Pain or cramps during your period
  • Constipation
  • Hemorrhoids

Levator Syndrome

Sometimes, spasms of a pelvic muscle called the "levator ani" cause pelvic pain.

Symptoms you may have:

  • Pain is related to sitting
  • Pain doesn't seem to be related to bowel movements
  • You wake up at night in pain
  • Pain usually lasts less than 20 minutes at a time

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