Written by the Amorae care team · Last reviewed · How we write our health content
Part of our chronic pelvic pain guide · Browse every question we answer
What causes chronic pelvic pain?
Understanding the complex web of reasons why pelvic pain persists for months or years. It is rarely just one thing—it is usually a combination of factors.
The short answer
Chronic pelvic pain (pain lasting longer than six months) is famously difficult to pin down to a single cause. For most women, it is a "pain sandwich"—a mix of gynaecological conditions, digestive issues, and muscular tension all feeding into each other.
Because the organs in your pelvis live so close together, when one area gets inflamed or tense, it often triggers the others. This is why you might find your IBS flares up at the same time as your period pain.
Common gynaecological causes
Around 20% to 30% of chronic pelvic pain is linked to gynaecological conditions. These often involve the lining of the womb or the ovaries.
- Endometriosis: Where tissue similar to the lining of the womb grows in other places, like the ovaries or fallopian tubes. It bleeds every month but has no way to leave the body, causing intense inflammation.
- Adenomyosis: Often called the "cousin" of endometriosis, this is where the womb lining grows into the muscular wall of the womb itself, making it heavy, inflamed, and painful.
- Fibroids and Cysts: Non-cancerous growths or fluid-filled sacs that can put pressure on surrounding organs and nerves.
- Pelvic Inflammatory Disease (PID): An infection of the female upper genital tract which can leave behind scarring and long-term sensitivity.
Digestive and bladder causes
A huge number of women with pelvic pain also struggle with their gut or bladder. The nerves in these areas share the same pathways to the brain.
Irritable Bowel Syndrome (IBS) is a common culprit. Bloating and constipation don't just cause gut ache; they put physical pressure on the pelvic floor. Similarly, Interstitial Cystitis (also known as painful bladder syndrome) causes chronic inflammation of the bladder wall, which feels very similar to a permanent UTI.
Muscular and nerve causes
Even if your pain started with a cyst or an infection, the muscles often "take over" the pain signals. This is called pelvic floor dysfunction.
When you are in pain for a long time, your pelvic floor muscles naturally contract to protect you. Eventually, they can become "hypertonic"—meaning they are stuck in a state of tension and can't relax. This creates a cycle where the muscle tension itself causes more pain, which leads to more tension.
Nerve entrapment or sensitivity (like Pudendal Neuralgia) can also play a role, where the nerves in the pelvis send out pain signals even when there is no active injury.
Medical Disclaimer
This article is for informational purposes and does not constitute medical advice. Chronic pelvic pain can be a sign of various conditions. If you are experiencing persistent pain, please consult a healthcare professional for a formal diagnosis and treatment plan.
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Amorae Intimate is a wellness CBD product. It is not a licensed medicine and is not intended to diagnose, treat, cure or prevent any medical condition. If you experience severe or persistent pelvic pain, or you have a diagnosed condition such as endometriosis, please speak to a healthcare professional. Do not use if pregnant or breastfeeding. For adults aged 18 and over, resident in the United Kingdom.