Pelvic pain often is related to a woman’s reproductive organs and structures of the pelvis. However, pelvic pain can occur from other causes. For women, pain in the pelvic region can be associated with problems of the uterus, ovaries, fallopian tubes, cervix, and/or vagina.
Pelvic pain is either acute (sudden and severe) or chronic (pain that is long-standing, constant, or comes and goes). According to the American College of Obstetricians and Gynecologists, if pelvic pain last for more than six months, and does not improve, it is considered chronic.
What are some common causes of pelvic pain?
- Bladder infection – Caused by various microorganisms.
- Sexually transmitted infection – Includes chlamydia, gonorrhea, bacterial vaginosis, and trichomonasis.
- Kidney infection – Includes infection of either or both kidneys.
- Kidney stone – A calcium stone lodged in the renal tissue.
- Ectopic pregnancy – A pregnancy that occurs outside the uterus.
- Pelvic inflammatory disease – Irritation and inflammation of the uterus and fallopian tubes.
- Ovulation – Some women have pain during ovulation.
- Ovarian cysts – Can be twisted or ruptured.
- Miscarriage – Occurs when there is a threatened abortion.
- Endometriosis – Painful tissue that grows outside the uterus.
- Uterine or ovarian cancer
- Uterine fibroids – Growths on or in the uterine wall.
- Intestinal disorders
- Broken pelvic bone
- Nerve conditions
- Psychogenic pain
- Scar Tissue from previous pelvic surgery
What symptoms are associated with pelvic pain?
Depending on the cause of pelvic pain, various symptoms associated with this type of discomfort include menstrual cramps, vaginal bleeding/spotting, vaginal discharge, painful urination, bloating, pain with intercourse, fever/chills, hip pain, groin pain, constipation, and diarrhea.
What are the different types of pelvic pain?
- Localized pain – May be related to inflammation.
- Sudden onset pain – Caused by temporary lack of blood supply due to obstruction in blood circulation.
- Colicky pain – Cause by spasm of a soft organ, such as ureter, intestine, or appendix.
- Slow pain – Develops gradually due to inflammation of the intestine or appendix.
- Pain aggravated by movement – Caused by irritation of the lining of the pelvic or abdominal cavity.
How does the doctor diagnose the cause of pelvic pain?
The doctor must take a detailed history and conduct a comprehensive physical examination to diagnose pelvic pain. There are several diagnostic tests done, as well. These may include:
- Blood, urine, and pregnancy testing
- Vaginal cultures to assess for STIs, such as chlamydia and gonorrhea
- Abdominal and pelvic x-rays and ultrasound
- Hysteroscopy to examine the uterus
- Laparoscopy, which is a minor surgery involving a small tube inserted into the pelvic area to assess for endometrial growths and uterine conditions
- Stool guaiac testing to evaluate for blood
- Endoscopy to assess the inside of the colon and rectum
- CT of the abdomen and/or pelvis to check for tumors and structural disorders
- Superior Hypogastric Plexus Block
What is the nonoperative treatment for pelvic pain?
The treatment of pelvic pain is related to the cause, and it depends on the intensity and frequency of the pain and discomfort. For infections of the reproductive organs or bladder, antibiotics are necessary.
Pain medicines are used for chronic pelvic pain, and oral contraceptives are prescribed to control menstrual disorders. One great treatment involves a superior hypogastric plexus block. This may provide both diagnostic and therapeutic treatment for pelvic pain, and can be repeated when necessary.