Pelvic Pain (with/without Endometriosis)

Pelvic pain can be caused by a number of different conditions. It can be associated with menstruation, ovulation, or intercourse. It can be acute, or it can be chronic, lasting for six months or more.

Dysmenorrhea (Menstrual Cramps)
Many women experience dysmenorrhea, or menstrual cramps, just before and during their period. Menstrual cramps range from merely annoying to severely painful. For many women, menstrual cramps will lessen with age and improve after giving birth. For others, however, there may be an underlying cause, such as endometriosis or uterine fibroids.

Mittelschmerz (Ovulation Pain)
Some women experience mittelschmerz, or pelvic pain on one side during ovulation, 12 to 16 days before menstruation. Mittelschmerz, which is German for “middle pain,” may last a few minutes, a few hours, or as long as a day or two. It can be dull and cramp-like or sharp and sudden. The pain occurs on the side of the ovary that’s releasing an egg, and it may switch sides every cycle or occur on the same side for several months. Tracking your menstrual cycles can help you determine whether you’re experiencing mittelschmerz or something else with an underlying condition.

Chronic Pelvic Pain
Chronic pelvic pain is pain in the pelvic region that lasts for six or more months and is not associated with a woman’s menstrual cycle.

For many women with chronic pelvic pain, their condition is caused by or associated with endometriosis. Endometriosis is a disease in which the endometrium, or the cells that line the inside of the uterus, grows outside the uterus. When the endometrium grows primarily on the ovaries, it’s called ovarian endometriosis.

In some cases, chronic pelvic pain may be caused by a condition other than endometriosis. Other conditions commonly associated with chronic pelvic pain include:

  • Pelvic floor muscle spasm
  • Interstitial cystitis, or painful bladder syndrome
  • Irritable bowel syndrome
  • Adhesions, which are fibrous bands of scar tissue that form between organs and other tissues

Chronic pelvic pain may radiate to other areas, such as the perineum, thighs, abdomen, and lower back.