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3.5 Minute

10-10-2024 Team Medicover woman-and-child

Written by Medicover Team and Medically Reviewed by Dr Tanuja Priyadarsini V, Gynecologist

Chronic Pelvic Pain After Menopause Causes, Symptoms, and Treatments

Chronic pelvic pain after menopause is a common but often overlooked issue for many women. It can feel like a constant or on-and-off pain in the lower belly area and may affect daily life. This type of pain can have many causes, including changes in hormones, past medical conditions, or problems with muscles or organs in the pelvic area.

Understanding the symptoms, causes, and treatment options can help women find relief and improve their quality of life after menopause.

What is Chronic Pelvic Pain?

Chronic pelvic pain is pain in the lower belly or pelvic area that lasts for six months or longer. It may come and go or be constant, and the pain can range from dull and achy to sharp and severe.

This condition can affect a person’s daily life, making it hard to work, exercise, or enjoy normal activities. Chronic pelvic pain can have many causes, including problems with the reproductive organs, bladder, bowels, muscles, or nerves.

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Why Does It Happen After Menopause?

After menopause, the body goes through hormonal changes, especially a drop in estrogen. This can affect the muscles, tissues, and organs in the pelvic area.

As a result, some women may begin to feel pain or pressure in the lower abdomen. Other possible causes include:

Pelvic floor muscle problems
Urinary tract issues (like infections or overactive bladder)
Digestive problems (such as constipation or irritable bowel syndrome)
Past surgeries or scar tissue
Endometriosis that continues after menopause
Emotional stress or anxiety

Causes of Chronic Pelvic Pain After Menopause

Hormonal Changes

One of the primary causes of chronic pelvic pain after menopause is hormonal changes. As women transition into menopause, estrogen levels decline, which can lead to various physiological changes.

Vaginal Atrophy: Reduced estrogen levels can cause thinning, drying, and inflammation of the vaginal walls, a condition known as vaginal atrophy. This can result in pain during intercourse and chronic pelvic discomfort.
Pelvic Floor Dysfunction: Hormonal changes can also weaken the pelvic floor muscles, leading to pelvic floor dysfunction, which can cause chronic pain.

Gynaecological Disorders

Several gynaecological conditions can contribute to chronic pelvic pain postmenopausal.

Endometriosis: Although endometriosis is more common in premenopausal women, it can persist or even develop after menopause, especially in those undergoing hormone replacement therapy.
Fibroids: Uterine fibroids are benign tumours that can cause significant pelvic pain. While they typically shrink after menopause, they can still be a source of pain for some women.
Ovarian Cysts: Postmenopausal women can still develop ovarian cysts, which can cause chronic pelvic pain if they become large or rupture.

Gastrointestinal Issues

Gastrointestinal disorders are another common cause of chronic pelvic pain in older women.

Irritable Bowel Syndrome (IBS): IBS is a chronic condition that affects the large intestine and can cause cramping, abdominal pain, bloating, and changes in bowel habits.
Diverticulitis: This condition involves inflammation or infection of small pouches that can form in the walls of the digestive tract, leading to significant pelvic pain.

Urological Conditions

Urological issues can also be a source of chronic pelvic pain after menopause.

Interstitial Cystitis: Also known as painful bladder syndrome, interstitial cystitis causes chronic pain in the bladder and surrounding pelvic region.
Urinary Tract Infections (UTIs): Recurrent UTIs can lead to persistent pelvic pain. Postmenopausal women are at higher risk for UTIs due to changes in the urinary tract linked to decreased estrogen levels.

Musculoskeletal Problems

Musculoskeletal issues, including problems with the bones, joints, and muscles, can also cause chronic pelvic pain.

Pelvic Congestion Syndrome: This condition involves varicose veins in the pelvis, which can cause chronic pain.
Myofascial Pain Syndrome: This syndrome involves chronic pain in the muscles and the fascia (the connective tissue covering the muscles), often resulting from pelvic floor dysfunction.

Symptoms of Chronic Pelvic Pain After Menopause

Chronic pelvic pain after menopause can feel different for each woman. It may be mild or strong and can affect your daily comfort and activities.

Common symptoms include:

Constant or off-and-on pain in the lower abdomen
Pressure or heaviness in the pelvic area
Pain during or after sex
Discomfort while sitting or standing for long periods
Pain when urinating or having a bowel movement
Lower back pain

Psychological Factors

Chronic pelvic pain is not solely a physical issue; psychological factors can also play a significant role. Stress, anxiety, and depression can exacerbate the perception of pain and make management more challenging. Addressing these psychological aspects is crucial for a comprehensive treatment approach.

Impact on Quality of Life

The emotional toll of chronic pelvic pain can be profound, impacting daily activities, relationships, and overall well-being. Support from mental health professionals, support groups, and effective pain management strategies is essential for improving quality of life.

Diagnosis of Chronic Pelvic Pain After Menopause

To find out what’s causing chronic pelvic pain after menopause, your doctor will start by asking about your symptoms and medical history. They may ask how long you’ve had the pain, where it hurts, and what makes it better or worse.

Next, the doctor may do a physical or pelvic exam to check for any problems in the lower belly or pelvic area.

You may also need some tests, such as:

Ultrasound to look at your uterus, ovaries, and other pelvic organs
Blood or urine tests to check for infection or other health issues
CT scan or MRI for a clearer view of your pelvic area, if needed
Laparoscopy a small surgery that lets the doctor look inside with a camera (used when other tests don’t give answers)

Treatment and Management

Medical Treatments

Effective management of chronic pelvic pain often requires a multidisciplinary approach.

Medications: Pain relievers, hormone replacement therapy, and medications to treat underlying conditions like IBS or interstitial cystitis can be beneficial.
Physical Therapy: Pelvic floor physical therapy can help strengthen the muscles and reduce pain.
Surgery: In some cases, surgical interventions may be necessary to address conditions like fibroids or ovarian cysts.

Lifestyle Changes

Adopting certain lifestyle changes can also help manage chronic pelvic pain.

Diet and Nutrition: A balanced diet can help manage gastrointestinal issues and overall health.
Exercise: Regular physical activity can improve pelvic floor strength and reduce pain.
Stress Management: Techniques like mindfulness, meditation, and yoga can help manage stress and reduce the perception of pain.

Complementary Therapies

Complementary therapies can be an effective addition to traditional medical treatments.

Acupuncture: This ancient practice can help alleviate chronic pain through targeted pressure points.
Chiropractic Care: Chiropractic adjustments can address musculoskeletal issues contributing to pelvic pain.
Massage Therapy: Regular massages can help relieve muscle tension and pain.

When to See a Doctor?

It’s important to see a doctor if you have pelvic pain that:

Lasts for six months or longer
Keeps coming back or gets worse over time
Affects your daily life, sleep, or mood
Happens during or after sex
Makes it hard to sit, stand, or move around
Comes with other symptoms like bleeding, fever, or weight loss

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Conclusion

Chronic pelvic pain after menopause is a multifaceted issue that requires a comprehensive approach for effective management. By understanding the various causes and incorporating a combination of medical treatments, lifestyle changes, and complementary therapies, women can find relief and improve their quality of life.

If you're experiencing chronic pelvic pain, consult with your healthcare provider to develop a personalized treatment plan that addresses your specific needs and concerns.

Frequently Asked Questions

Pelvic pain after menopause isn’t typical and may signal conditions like fibroids or ovarian cysts. It’s best to consult a doctor for a proper diagnosis and treatment.

The last stage is postmenopause, which starts 12 months after your final period. Hormone levels stabilize, but some symptoms like dryness or pain may continue for some women.

Yes, for many women, menopause-related pain eases over time as hormones stabilize. But some may have lingering symptoms and need ongoing lifestyle changes or medical help.

Exercise, eat well, stay hydrated, and manage stress. Hormone therapy or medications may help if pain is severe. Talk to your doctor for the best treatment plan for you.

Yes, body aches are common around age 55 due to aging and hormonal shifts. Joint stiffness and muscle pain are typical symptoms during or after menopause for many women.

A follicle-stimulating hormone (FSH) test is commonly used. High FSH and low estrogen levels usually indicate menopause. Your doctor may order additional hormone tests, too.