Fibromyalgia Pelvic Pain: A Comprehensive Guide To Managing It

Are you experiencing pelvic pain and think it's related to your fibromyalgia? This article explores the direct connection between fibromyalgia and pelvic discomfort. We'll highlight what may be causing it and provide insights into treating this chronic pain. So you can be well-equipped with the knowledge of how to manage it if it arises.

What is fibromyalgia pelvic pain?

Imagine you have a sharp, sudden pain or a constant, dull ache in your lower abdomen, hips, or pelvic area that just won't go away. This is what we call fibromyalgia-related pelvic pain – a persistent kind of discomfort that's similar to other long-term pelvic pain conditions and can be tricky to pinpoint. It might come with an increased need to pee, difficulty with bowel movements, or even symptoms that resemble irritable bowel syndrome (IBS), which all require careful attention and management.

Research shows that women with fibromyalgia often have more issues with the muscles at the bottom of their pelvis compared to those without the condition1. This can lead to several problems, including:

  • trouble holding urine
  • bowel control difficulties
  • constant pain in the pelvic area
  • pain during sexual activities.

Impact on sexual function & continence

Women with fibromyalgia often face greater challenges with their sexual health, impacting various stages of their sexual response. One study found that 18% experience pain during intercourse, while others struggle with muscle spasms in the pelvic area2. In comparison to individuals without fibromyalgia, those affected report a higher rate of urinary incontinence that mixes urgency with stress factors3.

What causes pelvic pain in fibromyalgia patients?

People with fibromyalgia often feel pelvic pain more intensely. This is because their central nervous system processes pain signals differently, making them more sensitive to pain that lasts a long time. This phenomenon is known as central sensitization and is like having a very sensitive car alarm that goes off in response to the slightest touch or even just a gentle breeze.

Also, if you have conditions like irritable bowel syndrome (IBS) or endometriosis along with fibromyalgia, your pelvic pain can get worse. It's interesting to note that many people with fibromyalgia, about half to 70%, also have IBS4.

The role of pelvic floor muscles in fibromyalgia

The muscles in your pelvic floor are quite important; they hold up your abdominal organs, help you manage when you go to the bathroom, play a role in sexual health, and are involved in childbirth.

For those with fibromyalgia, these muscles might not work as they should, leading to a condition called pelvic floor dysfunction. This impairment can lead to various problems such as the inability to control urination or bowels (urinary and anal incontinence), the descent of pelvic organs (pelvic organ prolapse), difficulties with sexual activity, and enduring pain within the pelvis5.

Urge incontinence, a prevalent urinary issue among fibromyalgia patients, manifests as an intense and immediate necessity to urinate accompanied by involuntary bladder muscle spasms. Additionally, there's a significant correlation between the intensity of fibromyalgia symptoms and the level of anxiety regarding pelvic floor functionality, which in turn affects urinary challenges.

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How to treat fibromyalgia pelvic pain?

Managing pelvic pain from fibromyalgia requires a holistic, multidisciplinary approach that involves using medication as an enabler, retraining your pain perception, and making lifestyle adjustments.


Medication plays an integral role in a comprehensive strategy to alleviate pain, designed to complement educational, lifestyle, and psychological approaches.

Standard pharmaceutical treatments encompass:

  • over-the-counter pain relievers like acetaminophen and naproxen to mitigate pain
  • antidepressants such as sertraline and fluoxetine, which serve dual purposes in managing both mood and pain symptoms
  • targeted pain relievers like Low Dose Naltrexone (LDN)
  • anticonvulsant drugs, proven to be effective in treating nerve pain, including topiramate and carbamazepine.

Retraining your pain

Grasping the concept of pain management requires us to understand that pain is not just a physical sensation. It's also tied to your emotions, your thoughts, and the environment you live in.

To tackle this pain, we start by identifying what makes it worse. This could be stress, negative thinking, or certain activities. Once we know these triggers, we can begin to change them. This might mean adjusting what you eat, improving how you sleep, adding some exercise, or using mental strategies to change how your brain perceives pain. With consistent effort and time, it's possible to rewire your brain to lessen the pain's impact on your life.

Stress management

Understanding stress management can profoundly improve your life. It's essential to learn techniques that prevent your body from mistaking everyday sensations for pain. There are several effective methods to lessen stress.

Cognitive behavioral therapy (CBT) and mindfulness meditation are two approaches that can reshape your thought patterns, anchor you in the present, and promote relaxation. Additionally, sharing your experiences with friends, a counselor, or a support group can offer you a space to voice your concerns and receive support and encouragement.

Movement & exercise

Engaging in regular movement and exercise is a crucial component in the management of pain. At first, it may appear challenging, yet the benefits are substantial. Exercise has the potential to enhance your mood, increase your energy levels, and improve the quality of your sleep. The objective is to identify physical activities that you enjoy and are appropriate for your condition.

Initiating your exercise regimen with gentle activities such as stretching or walking is advisable. These exercises can aid in the relaxation of your muscles. As your flexibility improves, you may experience a reduction in pain. This, in turn, can contribute to an overall sense of wellbeing.

It is important to commence with exercises that are gentle on your body. Pay close attention to your body's responses. Exercise self-compassion and avoid haste. A gradual progression in building strength and increasing activity levels is the safest approach to maintaining your wellbeing.

Physical therapy

Physical therapy is a powerful tool for addressing the pelvic pain that comes with fibromyalgia. Specifically, pelvic floor physical therapy focuses on easing pain in the muscles of the pelvic floor and abdomen. This therapy often involves direct, hands-on techniques to relax muscles and alleviate pain.

In addition to these manual techniques, physical therapists design programs for fibromyalgia patients that may include:

  • gentle manipulation by the therapist
  • exercises to improve heart health
  • aquatic exercises in a pool
  • stretching routines to enhance flexibility
  • strength training to build muscle support
  • yoga for balance and mind-body connection
  • tai chi for graceful, controlled movements
  • breathing techniques to help with relaxation.

Sleep quality

Ensuring restorative sleep is a cornerstone in the management of fibromyalgia and the mitigation of its associated pain. Individuals with fibromyalgia often struggle to achieve restful sleep, which is essential for the body's recovery processes.

To enhance your sleep and overall wellbeing, consider these guidelines:

  • Strive for a goal of eight hours of sleep per night and maintain a regular sleep routine.
  • Limit naps to brief periods to avoid disrupting your nighttime sleep.
  • Maintain daytime activity to promote easier sleep onset in the evening.
  • Reduce exposure to screens before bedtime to allow your mind to relax.
  • Create a sleep-conducive environment in your bedroom by ensuring it is dark and quiet.
  • Monitor your caffeine consumption, particularly in the latter part of the day, to prevent it from affecting your sleep.
  • Steer clear of large meals or alcohol prior to sleep, as they can impede your sleep quality.
  • Incorporate daily relaxation techniques to aid in sleep enhancement and better symptom management.

More information

At MoreGoodDays®, we're dedicated to guiding you through the complexities of managing fibromyalgia with knowledge and compassion. We understand the significant impact this condition can have on your everyday life. Our commitment is to provide you with resources and strategies that are both accessible and practical. Our aim is to support you on your journey to improved well-being, even in the face of fibromyalgia's challenges.

You can download our mobile app at no cost from the Apple App Store or Google Play Store. By doing so, you'll gain immediate access to our carefully curated resources and discover the various support options we offer.