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What contributes to persistent pelvic pain?

Persistent pelvic pain is a complex condition. On this page, you’ll learn about physical, psychological and social factors that can contribute to this type of pain.

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Physical health conditions and persistent pelvic pain

Many physical health conditions can contribute to persistent pelvic pain.

Period pain

Period pain is when your uterus muscles tighten at the start of your period. This pain can contribute to persistent pelvic pain.

Endometriosis

Endometriosis is when cells similar to those that line your uterus are found in other parts of your body, mainly in the pelvis. Pain is a common symptom of endometriosis, which can contribute to persistent pelvic pain.

Adenomyosis

Adenomyosis is when cells similar to those that line your uterus are found in the muscle wall of your uterus. Painful periods are a common symptom of adenomyosis, which can contribute to persistent pelvic pain.

Irritable bowel syndrome (IBS)

Irritable bowel syndrome (IBS) is a group of symptoms, such as bloating, constipation, diarrhoea and pain in your abdomen, which can contribute to persistent pelvic pain.

Pelvic floor dysfunction

Your pelvic floor muscles are part of a group of muscles called your ‘core’. Tight pelvic floor muscles can cause painful sex and pelvic pain, which can contribute to persistent pelvic pain.

Painful bladder syndrome

Painful bladder syndrome is a condition where you have bladder pain and a frequent and urgent need to wee. Symptoms include pressure, pain and tenderness in the pelvis, which can contribute to persistent pelvic pain.

Urinary tract infections (UTIs)

A urinary tract infection (UTI) is an infection that affects the urinary system, including the bladder, urethra and kidneys. Symptoms can include a burning sensation and pain in your lower belly when doing a wee, which can contribute to persistent pelvic pain.

Vulvodynia

Vulvodynia is the medical term for chronic pain or discomfort in the vulva that lasts for at least 3 months. With this condition, any pressure applied to the vulva, such as having sex, inserting a tampon or sitting for long periods of time can be unbearable. This condition can contribute to persistent pelvic pain.

Chronic pelvic pain syndrome

Chronic pelvic pain syndrome is when you have persistent pelvic pain without an underlying physical health condition.

Psychological factors that contribute to persistent pelvic pain

Psychological factors can contribute to persistent pelvic pain.

Stress

Stress activates your nervous, hormone and immune systems, which causes changes in your body and brain. These changes can affect you physically and psychologically, which can contribute to persistent pelvic pain.

Sleep

Poor sleep can increase the likelihood of pain and pain sensitivity. And pain can affect the quality and duration of your sleep. Disturbed sleep is also linked to depression and anxiety, which are more common with persistent pelvic pain.

Past trauma

Traumatic experiences, such as sexual assault and abuse, can contribute to persistent pelvic pain.

How you think about pain

The way you think about pain can influence the way your body responds and how you cope with it. If your nervous system is overly sensitive, even thinking about pain can make you feel pain. Being on ‘high alert’ for pain may also intensify your pain experience.

Social factors that contribute to persistent pelvic pain

Social factors, such as social connection and work environment, can contribute to persistent pelvic pain.

Social connection

If you live with persistent pelvic pain, it can be hard to engage in social activities or connect with others. This may cause you to withdraw and have fewer social contacts. But research shows that social isolation can make your pain worse, and it may also increase your risk of depression and anxiety.

Work environment

Your work environment can contribute to persistent pelvic pain. Poor job satisfaction, an unhappy workplace, lack of support from peers and employers, and shift work are also linked to increased pain.

This con­tent has been reviewed by a group of med­ical sub­ject mat­ter experts, in accor­dance with Jean Hailes pol­i­cy.

1
Giudice LC. Clinical practice. Endometriosis. N Engl J Med. 2010;362(25):2389-2398. doi:10.1056/NEJMcp1000274
2
Parasar P, Ozcan P, Terry KL. Endometriosis: Epidemiology, Diagnosis and Clinical Management. Curr Obstet Gynecol Rep. 2017;6(1):34-41. doi:10.1007/s13669-017-0187-1
3
Van Niekerk, L., Johnstone, L., & Matthewson, M. (2022). Health-related quality of life in endometriosis: The influence of endometriosis-related symptom presence and distress.Journal of health psychology, 27(14), 3121-3135.
4
Van Niekerk, L., Johnstone, L., & Matthewson, M. (2022). Predictors of self-compassion in endometriosis: the role of psychological health and endometriosis symptom burden. Human Reproduction, 37(2), 264-273.
5
Dowding, C., Mikocka‐Walus, A., Skvarc, D., Van Niekerk, L., O'Shea, M., Olive, L., ... & Evans, S. (2022). The temporal effect of emotional distress on psychological and physical functioning in endometriosis: A 12‐month prospective study.Applied Psychology: Health and Well‐Being.
6
Sivertsen B, Lallukka T, Petrie KJ, Steingrímsdóttir ÓA, Stubhaug A, Nielsen CS. Sleep and pain sensitivity in adults. Pain. 2015;156(8):1433-1439. doi:10.1097/j.pain.0000000000000131
7
Haack M, Simpson N, Sethna N, Kaur S, Mullington J. Sleep deficiency and chronic pain: potential underlying mechanisms and clinical implications. Neuropsychopharmacology. 2020;45(1):205-216. doi:10.1038/s41386-019-0439-z
8
Stacy J, Frawley H, Powell G, Goucke R, Pavy T. Persistent pelvic pain: rising to the challenge. Aust N Z J Obstet Gynaecol. 2012;52(6):502-507. doi:10.1111/j.1479-828X.2012.01473.x
9
Lamvu, G., Carrillo, J., Ouyang, C., & Rapkin, A. (2021). Chronic pelvic pain in women: a review. Jama, 325(23), 2381-2391.
10
Bannon S, Greenberg J, Mace RA, Locascio JJ, Vranceanu AM. The role of social isolation in physical and emotional outcomes among patients with chronic pain. Gen Hosp Psychiatry. 2021;69:50-54. doi:10.1016/j.genhosppsych.2021.01.009
11
Yamada K, Matsudaira K, Imano H, Kitamura A, Iso H. Influence of work-related psychosocial factors on the prevalence of chronic pain and quality of life in patients with chronic pain. BMJ Open. 2016;6(4):e010356. Published 2016 Apr 25. doi:10.1136/bmjopen-2015-010356
12
Matre D, Christensen JO, Mork PJ, Ferreira P, Sand T, Nilsen KB. Shift work, inflammation and musculoskeletal pain—The HUNT Study.Occupational Medicine. 2021;71(9):422-427. doi:https://doi.org/10.1093/occmed/kqab133
Last updated: 
04 July 2025
 | 
Last reviewed: 
01 July 2025

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