If possible, your doctor will want to identify the cause of your chronic pelvic pain, as the preferable form of treatment is to identify and resolve the underlying cause directly.If no definitive cause can be identified, your doctor will focus on managing your symptoms to get your pain under control.,


Simple painkillers target the affected area to reduce levels of prostaglandins, thus lessening the severity of pain as well. Simple painkillers are commonly purchased over the counter.
Dosage for adults is usually 500 mg tablets every four to six hours. An example of simple painkiller is ibuprofen (Advil).



Your doctor may prescribe hydrocodone (vicodin or norco), or oxycodone (roxycodone).
Dosage may vary depending upon the severity of the pain but normal dosage of oral Tramadol for adults is about 50–100 mg every four to six hours, for instance.
 So long as you are not trying to get pregnant or have any other conditions that would interfere with birth control, you may find that taking birth control pills can have a significant effect on decreasing chronic pelvic pain.This is particularly true if your pelvic pain is cyclical and linked to a part of your menstrual cycle. Many women have worse pain during ovulation (two weeks into their cycle), and during the menstrual period itself. If you find yourself with these cyclical symptoms, speak to your doctor about birth control or other hormonal treatment options.
 Be sure to finish the full course of antibiotics that your doctor prescribes, even if your symptoms begin to feel better, as finishing the full course helps to prevent any recurrent infections or complications down the road.



Examples include tricyclic antidepressants like amitriptyline or nortriptyline (Pamelor) which contain both pain relief and antidepressant properties.
Amitriptyline works on the brain and spinal cord by suppressing the pain signals that are sent to these areas. The recommended initial dose is 75 mg per day. The maintenance dose is 150 to 300 mg per day, which can be given in single or divided doses.
 Finding time to seek help from expert counselors could help ease the stress, thereby relieving pain sensations as well.


Cognitive behavior therapy (CBT) and biofeedback are two techniques that have both been shown to be helpful in treating chronic pain. You can speak to your counsellor about these options if they interest you to learn more about them.
 This increases blood flow to the area and helps to prevent the accumulation of irritants such as lactic acid that can cause pain.


TENS is done using a small, battery-powered machine that is about the size of a pocket radio. Two wires that conduct electrical impulses (electrodes) from the machine are attached to the painful area. When the current is delivered, you experience less pain.Aside from relaxing tight muscles, the electricity stimulates the nerves in the painful area and sends signals to the brain that block the normal pain signals. The doctor or physical therapist usually determines the correct settings of the TENS machine before treatment.
 These trigger points are knots of muscle that are formed when the muscles do not relax. They can often be felt beneath the skin and can cause pain when palpated or pressed upon.


During this procedure, the doctor will first locate the trigger point by palpating the knots of muscles. If pain occurs, then this is the target area. It will now be cleaned with an alcohol based solution.
Your doctor will give you an injection of a numbing medicine, usually a long-acting local anaesthetic such as bupivacaine and a small amount of steroid. The injection is given at the specific spot where you are feeling pain (the trigger point) to block the sensation and to provide relief., Surgical interventions are intended to correct underlying problems which may be causing the chronic pelvic pain. Doctors may recommend:


Laparoscopic surgery: If the cause of chronic pelvic pain is endometriosis, adhesions or endometrial tissues can be removed through this procedure. Your doctor will administer general anesthesia. A small incision will be made near the umbilicus to allow entry of an instrument called a laparoscope. This instrument will guide the doctors during the removal of endometrial tissues.Hysterectomy and bilateral oophorectomy: This procedure may be recommended for women past childbearing age who experience chronic pelvic pain. Your doctor will administer general anesthesia. An incision will be made in the abdomen, then the uterus and the ovaries will be removed. This leads to a deficiency of estrogen, a hormone which is needed by endometriosis (cysts that may aggravate chronic pelvic pain) for growth., Omega-3 fatty acids have been shown to reduce the production of several prostaglandins which are mainly responsible for activating the pain receptors in the body.Foods rich in omega-3 fatty acids are walnuts, flax seeds, sardines, salmon, shrimp, soybeans, tofu, cauliflower, Brussels sprouts and winter squash. The recommended dose for omega-3 fatty acids is not more than 3 grams daily.
 Studies show that engaging in strenuous exercise can boost the production of endorphins — also known as the "happy hormone" responsible for elevating your mood, reducing anxiety and depression, and fighting pain.


Endorphins interact with the brain receptors by blocking the path of pain signals going to the brain — the same way as stronger painkiller medications do.
If possible, you should exercise for at least 45 minutes a day such as brisk walking, jogging, cycling, stair stepping, swimming and weightlifting.
 Having a hot bath is another way to apply heat to your pelvic area, and to help the muscles relax, which can decrease pain and cramping.
 Things such as massage, acupuncture, or natural remedies have been shown to help in some cases. It is worth a shot if you prefer this to traditional medical treatments. Be sure you speak with your physician before pursuing alternative therapies.
 In other cases the pain may be caused by one of a number of different medical conditions such as the following:


Endometriosis: This is a condition wherein the tissues that line the uterus grow outside of it. As a result, tissue deposits build-up in the abdomen, potentially causing painful cysts and adhesions.
Tension in the muscles of the pelvic floor: If the pelvic muscle remains semi-contracted for a long time, then blood flow may be diminished in that area. Irritants such as lactic acid may build-up in the area causing sharp, gnawing, dull or excruciating pain.
Chronic pelvic inflammatory disease: This is caused by a chronic type of infection (commonly sexually transmitted) that causes scarring of the pelvic organs, thereby leading to a sharp, dull, gnawing or excruciating pain.
Ovarian residue: During a surgical operation such as complete hysterectomy (removal of the fallopian tubes, ovaries and uterus) tiny fragments of the ovary may be unintentionally left inside the system which can lead to the growth of painful cysts.
Fibroids: These are benign growths in the uterus which may exert pressure or weight on the lower abdomen. This condition seldom triggers throbbing pain unless the affected area lacks blood supply leading to degeneration or death.
Irritable bowel syndrome: The most common symptoms accompanied by IBS are constipation or diarrhea and bloating. These symptoms often stimulate discomfort and pressure on the pelvic area.
Interstitial cystitis (painful bladder syndrome): This is characterized by the chronic swelling of the bladder and the need to urinate regularly. Pelvic pain may progress when the bladder begins to fill up and temporary relief may be felt upon urination.
Psychological factors: Chronic pelvic pain may be aggravated by certain levels of stress and depression.
 The pain associated with chronic pelvic pain can be characterized as:


Persistent, constant, intermittent, dull, aching or cramping pain in the pelvis. Pain varies with different individuals, depending on the cause.
Weight or pressure on the pelvis. If the cause is a growing cyst, then the increase in size can put pressure on the pelvis.
Pain upon urination and bowel movement. The pressure exerted by the person when urinating or moving a bowel can cause pelvic pain.
Pain with prolonged periods of sitting and standing. Discomfort may be felt during such activities which can be mild or severe and may interfere with daily routine. The pain is usually relieved after lying down.
 Tests and procedures that may be used include:


History taking: A detailed interview will be conducted to determine any relevance of existing symptoms to previous medical conditions experienced by the patient. Personal and familial predisposition of the patient may be gathered as well.
Pelvic exam: During the procedure, the doctor will assess the pelvic area for any tenderness or changes in sensation. It is important that the patient tell the doctor if she feels any pain or discomfort, as this will guide them in making the right diagnosis. Signs of abnormal growth, infection and tense pelvic floor muscles usually suggest development of chronic pelvic pain.
Cultures: A cell or tissue specimen will be collected from the cervix or the vagina for laboratory analysis. The presence of an infection like chlamydia or gonorrhea may explain the condition.
Ultrasound: This procedure makes use of high-frequency sound waves to generate a clear and detailed picture of the structures within the pelvic area. Any irregularities may be the cause of chronic pelvic pain.
Laparoscopy: An incision will be made into the abdomen to allow passage of a thin tube with a small camera attached to its end (laparoscope). This procedure will help the doctors observe the pelvic organs and evaluate them for any signs of infection or the abnormal growth of cells which can be indicative of a chronic condition.
Start by identifying the cause.
Take over-the-counter painkillers.Over-the-counter (OTC) painkillers can reduce levels of pain by interrupting the production of a certain chemical called prostaglandin which controls pain sensations.
Get a prescription for stronger painkillers.Your doctor might prescribe stronger, narcotic painkillers if the simple painkillers are not working to relieve your symptoms.
Try birth control pills.
Treat bacterial infections with antibiotics.Chronic pelvic pain that is caused by an infection is commonly treated with antibiotics.
Consider taking antidepressants.These drugs can be helpful in treating several chronic pain syndromes, so they are sometimes prescribed for women with chronic pelvic pain who do not suffer from depression.
Look into counseling.Chronic pain may be caused by psychological factors such as depression, stress or personality disorder.
Ask your doctor about transcutaneous electrical nerve stimulation (TENS).With this therapy, electrodes are used to transmit electrical impulses into the nerve pathways, thereby helping doctors to determine and relax areas of tight muscles.
Opt for trigger point injections.TPI is a procedure used to treat painful areas of pelvic muscle that contain trigger points.
Undergo surgery as a last resort.Surgery is commonly the last resort if all other pain relief measures fail.
Eat foods rich in omega-3 fatty acids.
Exercise regularly.
Use a combination of heat and cold.Applying heating packs or cold ice to your pelvic area can help to diminish pain and to decrease inflammation.
Try alternative therapies.
Know the possible causes of chronic pelvic pain.Chronic pelvic pain sometimes occurs for no apparent reason and without specific cause.
Recognize the symptoms associated with chronic pelvic pain.
Understand how chronic pelvic pain is diagnosed.Diagnosing chronic pelvic pain may involve a process of elimination as several disorders may cause pelvic pain.
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