Treatment for chronic female pelvic pain can be approached in two ways: treating a known, specific cause of the pain or treating the pain itself as a medical condition. When it's possible, your doctor will do both.
Treating a known or suspected cause
Depending on the cause, treatment may include:
- Medicine to control or stop the ovulation cycle. This is done if cyclic hormonal changes seem to make your symptoms worse.
- Medicines to treat other diseases, such as an antibiotic for infection or medicine for irritable bowel syndrome.
- Cognitive-behavioral therapy, counseling, or biofeedback to treat depression or other mental health problems.
- Surgery to remove painful growths, cysts, or tumors.
- Healthy lifestyle choices, such as regular exercise to manage stress and improve strength, mood, and general health, along with dietary changes, such as those recommended to manage irritable bowel syndrome.
Treating the pain itself
Finding a treatment that works may take a while. It's common for women to try many treatments before finding one or more that help.
Medicines that may help manage your pain include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs). These medicines are the first-choice treatment for relieving pain and inflammation. They work well for menstrual pain. Be safe with medicines. Read and follow all instructions on the label.
- Medicines that control hormone levels, such as birth control pills. They sometimes work well for pain that seems to be caused or made worse by menstruation.
- Certain antidepressant medicines. These are used to treat chronic pain in other areas of the body also.
If your chronic pain hasn't responded to treatment or seems to have no physical cause, you may have neuropathic pain. This means that your nerves still create pain signals long after an original injury or disease has healed. If your doctor suspects that you have neuropathic pain, he or she may refer you to a pain management clinic for evaluation and treatment.
What to think about
Decisions are complicated when you are considering treatment for chronic pelvic pain. Think about these questions, and talk to your doctor about them:
- Are the symptoms bothersome enough to require treatment?
- Do you want to have a child or more children?
- Has a specific cause of the pain been discovered? Or is the cause unclear?
- Is menopause, which may stop symptoms, going to occur soon?
- Would an opinion from another doctor be helpful?
- Would an opinion from a doctor who specializes in chronic pain be helpful?
If you are close to menopause (usually around age 50) and your symptoms are likely related to hormones, your best option may be home treatment and medicine while you wait for menopause.
The hormone changes of menopause may get rid of your chronic pain, but the pain may come back if you use hormone therapy. If you are nearing menopause, talk with your doctor about your options.