Chronic Pelvic Pain in Fibromyalgia and Chronic Fatigue Syndrome

Chronic pelvic pain is a common problem in people with fibromyalgia (FMS) and chronic fatigue syndrome (ME/CFS). Those of us with these conditions can have pain just about anywhere, though, so this one may be hard to spot. It pays to be on alert for different sources of pain, though. Then, you can have them diagnosed and treated, which can improve your life and overall health.

A woman in the kitchen with pelvic pain
Fertnig / Getty Images

A key thing to remember is that pain from FMS and ME/CFS don't generally sit in the same place all the time. Also, in many cases, it comes and goes. If you consistently have pain in a certain area, or pelvic pain that's tied to specific causes such as sex, your menstrual cycle, or some other factor that you can identify, pay special attention to it and bring it up to your healthcare provider. Be sure to note the differences you've found between it and your "normal" pains.

Chronic pelvic pain isn't just one thing with one cause—it's actually an umbrella term for any condition that causes persistent pain in and around the pelvic cavity, which is the lower part of your abdomen. When you have cramping from menstruation or diarrhea, for example, that's in your pelvic cavity.

The Basics of Chronic Pelvic Pain

A lot of conditions can cause chronic pelvic pain. Research links only some of them to FMS and ME/CFS (those are indicated with an * in the list below.) When trying to make a diagnosis, your healthcare provider may want to start with the common overlapping conditions, but he or she may also explore some of the others, as well. It will likely depend on your specific symptoms.

Several conditions that can cause chronic pelvic pain are gender-specific. Causes specific to women include:

  • Vulvodynia
  • Dysmenorrhea (painful period)
  • Endometriosis
  • Uterine fibroid tumors
  • Pelvic joint instability linked to childbirth

Some common causes specific to men are:

  • Chronic prostatitis (inflammation of the prostate)
  • Penile or testicular pain syndromes
  • Post-vasectomy pain syndrome

Causes that are not necessarily related to gender include:

  • Irritable bowel syndrome (IBS)
  • Interstitial cystitis (IC), also called painful bladder syndrome
  • Tumors
  • Chronic kidney stones
  • Nerve damage (neuropathy)
  • An injury in the pelvic region

Symptoms, treatments, and diagnostic procedures vary based on the specific cause of pelvic pain. The sheer number of possibilities can make it tough to figure out, so it may take a long time for you to get a proper diagnosis. That's unpleasant when you're miserable, but keep in mind that the right answer and, especially, the right treatment are what you're after. It may take some experimentation before your healthcare provider knows exactly what's going on.

Why Is Chronic Pelvic Pain Linked to FMS & ME/CFS?

While we don't fully understand the relationships between these conditions, some researchers now believe FMS, ME/CFS, and many causes of chronic pelvic pain are all in a "family" of illnesses called central sensitivity syndromes (CSS).

All CSS involves an underlying mechanism called central sensitization, which involves abnormalities in your brain and nerves that make you extremely sensitive to a variety of things, such as pain, temperature, and sound.

Chronic Pelvic Pain in FMS & ME/CFS

Chronic pelvic pain, like any pain source, may cause symptoms of FMS or ME/CFS to intensify. Proper diagnosis and treatment of overlapping conditions is an important part of quieting all your symptoms and improving your life.

Because some symptoms are common to multiple CSS, you may get double duty out of certain treatments, such as pain medications (NSAIDs, opiates) and SSRI/SNRI antidepressants.

If you believe you have chronic pelvic pain, talk to your healthcare provider to get the diagnostic process started.

10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Abbi B, Natelson BH. Is chronic fatigue syndrome the same illness as fibromyalgia: evaluating the 'single syndrome' hypothesisQJM. 2013;106(1):3–9. doi:10.1093/qjmed/hcs156

  2. Bernardi M, Lazzeri L, Perelli F, Reis FM, Petraglia F. Dysmenorrhea and related disordersF1000Res. 2017;6:1645. doi:10.12688/f1000research.11682.1

  3. Nickel JC. The multidisciplinary approach to defining the urologic chronic pelvic pain syndromes: report from a national institutes of health workshop, december 13-14, 2007, Baltimore, MDRev Urol. 2008;10(2):157–159.

  4. Passavanti MB, Pota V, Sansone P, Aurilio C, De Nardis L, Pace MC. Chronic Pelvic Pain: Assessment, Evaluation, and ObjectivationPain Res Treat. 2017;2017:9472925. doi:10.1155/2017/9472925

  5. Sadownik LA. Etiology, diagnosis, and clinical management of vulvodyniaInt J Womens Health. 2014;6:437–449. doi:10.2147/IJWH.S37660

  6. Smith CP. Male chronic pelvic pain: An updateIndian J Urol. 2016;32(1):34–39. doi:10.4103/0970-1591.173105

  7. Cho YS. Interstitial Cystitis/Bladder Pain Syndrome: A Urologic MysteryInt Neurourol J. 2016;20(1):3–4. doi:10.5213/inj.1620edi.002

  8. McGowan L, Escott D, Luker K, Creed F, Chew-Graham C. Is chronic pelvic pain a comfortable diagnosis for primary care practitioners: a qualitative studyBMC Fam Pract. 2010;11:7. doi:10.1186/1471-2296-11-7

  9. Gracely RH, Schweinhardt P. Programmed symptoms: disparate effects united by purposeCurr Rheumatol Rev. 2015;11(2):116–130. doi:10.2174/1573397111666150619095125

  10. Slater D, Kunnathil S, McBride J, Koppala R. Pharmacology of nonsteroidal antiinflammatory drugs and opioidsSemin Intervent Radiol. 2010;27(4):400–411. doi:10.1055/s-0030-1267855

Additional Reading

By Adrienne Dellwo
Adrienne Dellwo is an experienced journalist who was diagnosed with fibromyalgia and has written extensively on the topic.