Chronic Female Pelvic Pain: Medications

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Medications

Treatment with medication does not cure female pelvic pain. However, controlling pain can help prevent it from getting worse or becoming chronic.

Medication Choices

The following may help relieve symptoms:

• Prescription nonsteroidal anti-inflammatory drugs (NSAIDs), taken on a regular schedule, help relieve pain caused by inflammation or menstruation. If one type doesn't work for you, your health professional may recommend that you try at least one other before stopping NSAID therapy.
• Birth control pills (oral contraceptives) are commonly prescribed to reduce painful menstruation. Oral contraceptives are often prescribed for endometriosis-related pain, though there is little research that shows them to be effective.¹
• High-dose progestin is sometimes prescribed to relieve pain related to endometriosis.¹
• Gonadotropin-releasing hormone agonists (GnRH-As) can relieve endometriosis-related pain by stopping production of the hormones that make endometriosis worse. GnRH-A treatment may also relieve cyclic pelvic pain not related to endometriosis, as well as pelvic pain related to irritable bowel syndrome.¹ However, this short-term treatment induces menopause, with side effects such as hot flashes and loss of bone density, for as long as you take it. For more information, see the topic Endometriosis.
• Tricyclic antidepressant medications (TCAs) are sometimes used to treat chronic pain in other areas of the body. Limited research suggests that TCA therapy decreases chronic pelvic pain intensity for some women.¹
• Narcotic pain medication is only recommended as a last-resort treatment for severe pelvic pain because of the risk of addiction.

What To Think About

No single medication successfully treats chronic pelvic pain in all women.

Treating chronic pelvic pain with medication is usually preferable to using a surgical option. Surgery is only recommended when a correctable cause of pain is clearly known. Even in these cases, there are no guarantees that surgery will relieve pain or that it will not cause further problems.

Chronic pelvic pain symptoms sometimes stop naturally when menopause occurs. If you are close to menopausal age (usually around age 50) and your symptoms are likely related to hormones, your best option may be home treatment and medication until menopause occurs.

Last updated:	January 30, 2007
Author:	Kathe Gallagher, MSW
Reviewed By:	Renée M. Crichlow, MD - Family Medicine, Kirtly Jones, MD - Obstetrics and Gynecology
Editors:	Kathleen M. Ariss, MS, Pat Truman, MATC