Ongoing Pelvic Pain After 50: Causes Beyond Your Uterus and How to Track It

Chronic pelvic pain is pelvic pain that lasts 6 months or longer.¹ It doesn’t have to happen every day to count, and it can affect work, activity, sex, sleep and family life.¹

It may not be gynecologic

ACOG¹ notes that many causes aren’t related to the reproductive organs at all.¹ Possibilities include:

• The bladder. See bladder pain syndrome.
• The bowel. See IBS and diverticulitis.
• The back and pelvic muscles, including muscle spasms and tender trigger points in the belly, vagina or low back.¹ See a tight pelvic floor.
• More than one cause at once, or sometimes no cause found.¹

ACOG¹ adds that about half of women with chronic pelvic pain have a history of trauma, but physical causes should always be looked for, and pain still deserves treatment even if no disease is found.¹

Keep a pain journal

ACOG¹ suggests recording:¹

• When the pain started and how often it happens
• How severe it is and how it affects daily life
• Whether it comes before, during or after eating, peeing, bowel movements, sex, activity or sleep
• What it feels like: sharp or dull, steady or in waves, in one spot or spread out
• What makes it better or worse
• Medicines and supplements you’ve tried

Tests you may have

Depending on your symptoms and exam, tests may include an ultrasound, a look inside the bladder (cystoscopy) or bowel (colonoscopy), and other imaging or lab tests.¹

Treatments that can help

There’s rarely one easy fix, and several treatments may be used together.¹

• Treating a specific cause when one is found¹
• Medicines such as certain antidepressants, nerve pain medicines or muscle relaxers¹
• Lifestyle steps: posture, regular activity, diet, sleep and social connection¹
• Procedures such as nerve stimulation or injections¹
• Acupuncture or acupressure¹
• Pelvic floor physical therapy for muscle-related pain; see pelvic floor therapy costs

Our guide to new bloating after 50 explains when pelvic symptoms need a prompt check.

Try: “I’ve had pelvic pain on and off for eight months, worse after bowel movements and sex. Here’s my pain journal. Could this be my bowel, bladder or pelvic muscles?”

Down There, Decoded includes a Down-There Log and a See script for appointments. Use them as your pain journal to bring to your visit. Explore the intimate-health playbook.