Pelvic Pain, Decoded

No more suffering in silence! Get to the bottom of what’s really causing your lower belly aches.

- Hallie Levine

MINOR CRAMPS WHEN YOU HAVE your period? Totally normal. But chronic pelvic pain—meaning it lasts more than six months—is a whole different story, and up to one in four women may experience it, according to a 2014 review published in Pain Physician. “Pelvic pain is a big puzzle that can be caused by many factors,” says Barbara Diakos, MD, a gynecologist at Northwestern Medicine Lake Forest Hospital. “That’s why it’s so important for your doctor to listen to you, to hear what all your symptoms are, and to take you seriously.” (If she doesn’t, find another gyno for a second opinion.) The good news is that once you and your doctor play detective to pinpoint the cause of pelvic pain, there’s plenty you can do to relieve it. Read on for the most common culprits.

Culprit #1:

IT’S A GYNO THING

One major cause of pelvic pain is endometriosis, in which the tissue that lines the inside of your uterus, called your endometrium, grows outside the uterus. The pain can range from mild to excruciating; it’s often related to menstruation— it can start a few days before and continue through your period—but can occur at any time. Endo can also cause pain during sex and while having a bowel movement. It affects about 10 percent of all reproductive-age women, but it’s woefully under diagnosed, says Mark Dassel, MD, director of the Center for Endometriosis at the Cleveland Clinic: It can take from 5 to 20 years to get the right diagnosis.