Amitriptyline is one of the most useful medications for managing pelvic pain because it helps several different symptoms at once. It doesn’t suit everyone, but if you are someone with pain on most days it often improves pain. Around 1 in every 2 people who try it find it helpful.
Amitriptyline isn’t a pain killer, so you won’t feel better straight away, but when taken every day in very small doses it can help a range of different problems including:
- A sharp or burning pain.
- An overactive bladder. You may need to go to the toilet often, get up at night to pass urine or rush to the toilet.
- A pelvis where everything just feels ‘sensitive’.
- Painful pelvic muscles or tender points in other muscles like your neck or shoulders
- Migraine or other headaches
- An irritable bowel
- Poor sleep
- Painful vulval skin
- A bloated feeling
A long time ago, Amitriptyline used to be used in high doses (around 150mg daily) to treat depression, and it is still called a ‘tricyclic anti-depressant’ on the packet insert, even though no-one uses it for that anymore. If you are depressed there are newer and better medications (such as Duloxetine) you can use, if you need them.
For pelvic pain we use Amitriptyline in low doses (5-25mg daily). This dose can be continued long term if it suits you.