What Increases Your Risk

Risk factors are things that increase your chances of getting a certain condition or disease. Risk factors for pelvic pain that becomes chronic include:

• Pregnancy and childbirth that put stress on the back and pelvis, such as delivery of a large baby, a difficult delivery, or a forceps or vacuum delivery.
• History of physical or sexual abuse. About half of women with chronic female pelvic pain report abuse in their past.¹
• History of pelvic inflammatory disease.
• History of radiation treatment or surgery of the abdomen or pelvis. This includes some surgeries for urinary incontinence.
• History of depression. Pain and depression seem to be related.
• Alcohol or drug abuse.
• Something abnormal in the structure of the female organs.

When To Call a Doctor

Call a doctor for immediate care if you have sudden, severe pelvic pain, with or without vaginal bleeding.

Call a doctor if:

• Your periods have changed from relatively pain-free to painful.
• Pain interferes with your daily activities.
• You start to have pain during intercourse.
• You have painful urination, blood in your urine, or an inability to control the flow of urine.
• You have blood in your stool or a significant, unexplained change in your bowel movements.
• You notice any new pelvic symptoms.
• You haven't yet seen a doctor about your chronic pelvic pain.

Watchful waiting

Watchful waiting is a period of time during which you and your doctor watch your pelvic pain symptoms without using medical treatment.

During this period, you can keep a daily record of your symptoms and menstrual cycle and any other life events that you consider important. A watchful waiting period may last from a few days to weeks or possibly months.

Who to see

The following primary health professionals can generally evaluate and help you manage the symptoms of female pelvic pain:

• Family medicine doctor
• Gynecologist
• Internist
• Urologist
• Nurse practitioner
• Physician assistant

For advanced treatment methods, see a gynecologist or a urologist who specializes in female pelvic disorders.

If you have ever been physically or sexually abused, that trauma may be playing a part in your pain. So you'll need to let your doctor know about the abuse. This may be hard for you, but it may be easier if you find a doctor you feel comfortable talking to.

To prepare for your appointment, see the topic Making the Most of Your Appointment.