What causes chronic pelvic pain?

Female pelvic pain is typically caused by a medical condition involving the reproductive organs, urinary tract, lower gastrointestinal tract or muscles of the abdominal wall. Some causes are always short-term (acute), and others can become long-lasting (chronic) unless successfully treated. Sometimes, no cause can be found.

Pain with no known cause: Experts don't yet understand all possible causes of pelvic pain, especially when it has become chronic. So even after a lot of testing, many women never find out the reason for their pain. One reason might be what's called neuropathic pain. Long after a disease or injury has healed, nerves can continue firing pain signals. This is thought to be caused by an overloading of the nervous system by extreme or long-lasting pain. Not finding a cause doesn't mean that there isn't one or that there's no possible treatment.

Problems with the reproductive system that can cause chronic pain:

• Endometriosis. This is when the tissue lining the inside of the uterus starts growing outside of the uterus.
• Adenomyosis. This is when the lining in the uterus starts growing into the uterine muscle.
• Noncancerous (benign) tumors of the uterus, such as fibroids or polyps.

• Scar tissue (adhesions) inside the pelvis and belly. This is usually caused by pelvic inflammatory disease, radiation treatment or surgery.
• Bowel problems, such as irritable bowel syndrome.
• Urinary tract problems, such as bladder inflammation.
• Various cancers that occur in the pelvic area..
• Muscle spasm or pain in the lower abdominal wall muscles. This is sometimes linked to past surgery in that area.
• Pelvic congestion syndrome. This is a problem caused when veins in the pelvis don't drain properly and get enlarged or twisted as a result.

Physical or sexual abuse: Although the link isn't well understood, past or current abuse is strongly linked to chronic pelvic pain.