Remember New Years Day when you decided to jump-start your weight-loss program—by doing 500 sit-ups? That robo-routine could be the reason for the chronic ache in your pelvis. Then again, maybe not. One in seven women suffers from chronic pelvic pain, and the cause is often a mystery. To get relief, your first step (after the totally legit complaining) should be figuring out whats wrong. Talk to your doctor about these possibilities, and to rule out ovarian cancer (which is rare):
Its gynecological. Endometriosis—when uterine tissue grows outside the uterus—could be the culprit; roughly 10 percent of women have it. Also, prolonged pushing, a difficult forceps delivery, or certain types of incisions or lacerations during a vaginal delivery could lead to chronic pain. But dont just assume its a female problem, cautions OB-GYN Andrea Rapkin, MD, director of the University of California, Los Angeles, Pelvic Pain Clinic.
Its physical. Maybe it sounds odd, but a size mismatch between you and your partner could be to blame. If his penis is big, sex can bruise your cervix or tear the opening of your vagina. An injury from a fall could be responsible, too.
Its intestinal or urological. Chronic constipation may trigger pain in the muscles of the pelvic floor, and malfunctions such as colitis, irritable bowel syndrome (IBS), and diverticulitis might feel like something more gyno than gastro. IBS is more common in women than men and often includes pain with constipation or diarrhea. Then theres interstitial cystitis, a chronic inflammation in the bladder that can lead to pain, pressure, and tenderness.
And remember: Its fixable. The pain may be chronic, but you dont have to suffer. Experts say all of these underlying problems are treatable. Remedies may include hormonal therapy, antibiotics, pain relievers, antidepressants, counseling, relaxation exercises, physical therapy, or even surgery. And exhale now if fear of a disease like ovarian cancer is keeping you from seeing a doctor; pelvic pain is rarely a symptom. In fact, Rapkin says the chances of cancer being the problem are very low among premenopausal women.