Chronic Pelvic Pain

• Endometriosis: Endometriosis is a problem with the lining of the uterus. Tissue from the lining of the uterus moves through the fallopian tubes and gets on your ovaries, in your pelvis, on your bladder or in other areas. When you have your period, this tissue swells and bleeds, just like the lining of your uterus. This is often painful, and scar tissue can form in your pelvic area.
• Pelvic Inflammatory Disease: Pelvic inflammatory disease (PID) is an infection in the female reproductive organs (uterus, fallopian tubes and ovaries). Normally, the cervix (opening to the womb) prevents bacteria in the vagina from spreading up into these organs. However, if the cervix is exposed to a sexually transmitted infection (STI) such as gonorrhea or chlamydia, it becomes infected. This can allow bacteria to travel up into the internal organs, making them inflamed and infected. If this occurs, the woman's fallopian tubes may be damaged, making it difficult for her to become pregnant.
• Fibroids: Fibroids are benign growths (not cancer) in the muscular wall of the uterus. These growths can be very tiny or as large as a cantaloupe.
• Ovarian remnant: During a complete hysterectomy, the uterus and ovaries are removed. Sometimes a small piece of the ovary gets left behind, and that can develop painful cysts.

• Irritable bowel syndrome: Irritable bowel syndrome (IBS) is a common problem with the intestines. In people with IBS, the intestines squeeze too hard or not hard enough and cause food to move too quickly or too slowly through the intestines.
• Interstitial cystitis: Interstitial cystitis is a chronic bladder problem. People with interstitial cystitis have a bladder wall that is inflamed and irritated (red and sore). This inflammation can scar the bladder or make it stiff. A stiff bladder can't expand as urine fills it. In some cases, the walls of the bladder may bleed slightly. A few people get sores in the bladder lining.
• Past or present sexual abuse: If you have been the vicitim of sexual abuse, you are more likely to experience chronic pelvic pain.

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• Is the pain related to your menstrual cycle?
• Is it related to bowel movements?
• Does it hurt during urination or sexual activity?
• Have you had an infection?
• Have you had surgery in your pelvic area?

• Stopping ovulation (release of eggs from the ovary) with birth control pills or Depo-Provera injections
• Use of nonsteroidal anti-inflammatory pain relievers such as ibuprofen (one brand name: Motrin) or naproxen (brand name: Aleve)
• Relaxation exercises, biofeedback (treatment to control emotional states using electronic devices) and physical therapy
• Abdominal trigger point injections. A trigger point is a tender area in the lower wall of the abdomen. Pressure that is put on this area causes pain. Injecting medicine into the trigger point can block this pain
• Antibiotics
• Psychological counseling
• Surgery is usually only an option if abnormalities in the pelvis are seen

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