Understanding Chronic Pelvic Pain

Pain in the pelvic area – below the bellybutton and between the hips – lasting six months or longer is called chronic pelvic pain. It can be sharp or dull. It can be steady or intermittent. It can occur all the time or only during menstruation, while having a bowel movement, during intercourse, or even while sitting or lying down.

Possible causes include, but are not limited to:

  • Pelvic floor muscle spasms or tension
  • Chronic constipation or diarrhea
  • Urological or colorectal conditions
  • Endometriosis (when uterine tissue grows outside the uterus)
  • Improper musculoskeletal alignment
  • Chronic pelvic inflammatory disease
  • Uterine fibroids (non-cancerous growths)
  • Irritable bowel syndrome (bloating, constipation and diarrhea)
  • Interstitial cystitis (chronic bladder pain or pressure)


Diagnosing pelvic pain can be a challenge, as it can be difficult to pinpoint exactly where the pain arises. Diagnosis typically begins with a pelvic exam, followed by one or more of these common diagnostic tests:

  • Lab analysis – to check for bacterial, fungal or viral infections
  • Pelvic ultrasound – to examine pelvic organs and identify painful areas
  • Magnetic resonance imaging (MRI) – to look for congenital abnormalities
  • Abdominal x-rays or computerized tomography (CT) scans – to detect abnormal structures or growths
  • Colposcopy – which uses a lighted, magnified scope (or tube) inserted into the vagina to examine the cervix and vaginal tissues
  • Cystoscopy – which uses a scope inserted into the urethra (the tube that carries urine out of the bladder) to examine the lining of the bladder and urinary tract
  • Laparoscopy – which uses a thin, lighted scope inserted through a small incision in the lower abdomen to check for cysts, adhesions or scar tissue
  • Colonoscopy – which uses a thin, lighted scope inserted into the rectum and into the colon to check for cancer or polyps
  • Flexible sigmoidoscopy – which looks for cancer or polyps inside the rectum

Treatment Options

Depending on the diagnosis, treatment could include one or more of the following options:

  • Hormone treatments – various medications including birth control pills can help relieve cyclic pain caused by endometriosis
  • Other medications – including pain relievers, antibiotics for infections or antidepressants
  • Physical therapy – including vaginal relaxation and pelvic floor (Kegel) exercises
  • Biofeedback or electrical stimulation – to assist with Kegel exercises or with relaxation and stretching of the pelvic floor
  • Injections of a numbing medication – to block nerve pain and relax muscle spasms
  • Laparoscopic surgery – to remove adhesions or endometrial tissue

The MyMichigan Difference

  • MyMichigan offers DaVinci Robotic Surgery to enable advanced minimally invasive procedures for many complex surgeries.
  • MyMichigan facilities are conveniently located in safe and friendly communities, with easy access and parking. 

Your Next Steps

For more information about chronic pelvic pain, talk to your physician. For a physician referral, visit our Find a Doctor section, or call the MyMichigan Health Line at (989) 839-9090 or toll-free at (800) 999-3199.