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Causes and Symptoms of Chronic Pelvic Pain


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 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

Pelvic Support Problems

Sometimes women have pelvic pain when the muscles and ligaments that hold organs in place weaken. This causes organs like the uterus, the bladder, or the rectum to move from their normal places and herniate into the vagina. The vagina may also change shape. Pregnancy and giving birth may cause these kinds of problems.

Symptoms you may have:

  • Leaking urine
  • Feeling like something is falling out of your vagina
  • Difficulty with bowel movements
  • Lower back pain
  • Pain during sex
  • Pelvic organs bulge into the vagina, or even stick out the vaginal opening, in severe cases


Vulvodynia is pain that affects the vulva for no apparent reason. The pain of vulvodynia may be constant or it may come and go.

Symptoms you may have:

  • Burning or stinging sensations in the vulva
  • Pain when something presses on the vulva, like during sex or when you straddle a seat
  • Pain in your inner thighs

Psychological Causes

For some women, the root of pelvic pain is psychological. That's not to say that the pain isn't real. There just isn't an identifiable physical cause. Some people have emotional problems that only show up as physical symptoms. Women who have suffered sexual abuse or assault often have chronic pelvic pain afterward.

Symptoms you may have:

  • Depression
  • Anxiety
  • Substance abuse
  • Stress
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Reviewed on February 21, 2013
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