Pelvic pain

Pelvic pain is pain felt in the lowest part of the abdomen and pelvis, and it is called chronic when it lasts six months or longer.

The pelvis houses the bladder, bowel, reproductive organs, and a floor of muscles and ligaments, so pain there can arise from many sources, including endometriosis, painful menstruation, irritable bowel syndrome, interstitial cystitis, pelvic floor muscle dysfunction, adhesions after surgery, and nerve entrapment. In many people more than one source contributes, and in a substantial share no single cause is found even after thorough evaluation. Chronic pelvic pain is common in women of reproductive age but also occurs in men, where prostate and pelvic floor problems are frequent contributors.

Typical features include a dull, cramping, burning or pressure-like pain that may be constant or cyclical, pain with intercourse, bladder or bowel symptoms, and fatigue and low mood that accompany persistent pain. Assessment involves a detailed history that maps pain to the menstrual cycle, bladder and bowel function and activity, a physical and pelvic examination, imaging such as ultrasound, and sometimes laparoscopy. Because the condition often involves central sensitization, evaluation also considers sleep, stress and mood. Cannabinoids have been studied for pelvic and endometriosis-related pain in small surveys and early trials, but controlled evidence is limited and no such product has an approved use.