Chronic Pelvic Pain is defined as pelvic pain lasting 6 months or longer that is severe enough to affect quality of life and/or require treatment. It occurs below the umbilicus (navel), primarily in the lower abdomen, as an intermittent or a constant issue. The pain can be a mild ache or it can be severe pain that causes interruption to normal daily activities. Some women will experience pain during their menstrual cycle, during ovulation, during or after intercourse or with urinary or bowel movements.


Chronic Pelvic Pain is a complex problem that is caused by numerous diseases and conditions. Pelvic pain can be acute, chronic or cyclic and usually is associated with urination, defecation, intercourse and/or physical activity. Cyclic pelvic pain is typically associated with menstruation. Common causes of CPP include reproductive organs (gynecologic), the bladder (urologic), intestines (gastrointestinal), and pelvic muscles and joints (musculoskeletal).

Gynecologic Causes

Gynecologic causes account for about 20% of chronic pelvic pain and include:

  • Endometriosis
  • Pelvic Inflammatory Disease (PID)
  • Adhesions (Scar Tissue)
  • Pelvic Congestion Syndrome
  • Adenomyosis
  • Ovarian Tumor or Pelvic Mass
  • Fibroids

Urologic Causes

The most common urologic cause of CPP is interstitial cystitis, otherwise known as painful bladder syndrome. Other urologic causes include:

  • Recurrent Urinary Tract Infection
  • Urethral Diverticulum
  • Bladder Cancer

Gastrointestinal Causes

Bowel Dysfunction is the primary gastrointestinal cause of CPP, including Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease. Other gastrointestinal causes include:

  • Diverticulitis
  • Colon Cancer
  • Chronic Constipation
  • Celiac Disease.

Musculoskeletal Causes

The most common musculoskeletal cause of CPP is Fibromyalgia. Other musculoskeletal causes include:

  • Pelvic Floor Muscle Spasms
  • Chronic Abdominal Wall Pain
  • Inflammation Of The Pubic Bone
  • Hip, Joint And Muscle Tendon Abnormalities


Treatment of Chronic Pelvic Pain can be difficult and is very dependent on the diagnosis and cause of pain, if it can be determined. Some conditions prove unresponsive to surgical or medical interventions. Treatment of these conditions relies on pain and symptom management.


Antibiotics, hormones or pain medication may be prescribed to help alleviate pain or conditions causing pain. Conditions frequently treated with medication include:

  • Pelvic Inflammatory Disease
  • Urinary Tract Infections
  • Interstitial Cystitis
  • Pelvic Congestion Syndrome


Surgical interventions may be necessary to diagnosis and treat underlying causes of pain, including:

  • Adhesions
  • Adenomyosis
  • Endometriosis
  • Pelvic/Ovarian Mass
  • Pelvic Congestion Syndrome
  • Fibroids