Pelvic Pain

Pelvic pain is discomfort that occurs in the lowest part of the torso, the area below the abdomen and between the hipbones. It does not include pain that occurs externally in the genital area (vulva). Many women have pelvic pain. Pain is considered chronic if it continues to occur for more than 4 to 6 months.

Symptoms of Pelvic Pain

In many cases, it is often a woman who suffers from pelvic pain rather than a man. However, regardless of gender, pelvic pain should be taken seriously because there may be serious underlying medical issues causing the pain. The pain can be short and sudden or it can last longer than six months. Depending on the cause of your pelvic pain will determine your symptoms; such as pelvic pain with bleeding from the rectum during your period could be a sign that you have Endometriosis.

Pelvic pain can come with a large variety of symptoms that can cause mild to severe discomfort such as:

• Bloating in the abdomen
• Pelvic pain/cramps before or during menstruation
• Pain during/after sex
• Infertility
• Constant urge to urinate
• Pressure or tenderness in the lower abdomen
• Fatigue/fever/nausea
• Irregular or missed periods
• Lower back pain

There are many other symptoms of pelvic pain and what may be causing it, so it is important to be seen by a medical professional in order to give you proper treatment.

Causes of Pelvic Pain

There are several different diseases and conditions that can cause pain and inflammation of the pelvis. If you have chronic pelvic pain, there can be multiple conditions that are causing it. Conditions with the urinary, digestive, or reproductive system can cause pelvic pain, but doctors have recently discovered that the pain can also arise from connective tissue (ligaments) and muscles in the pelvic floor structures. Pain can sometimes be caused by nerve irritation in the pelvis.

The female reproductive system is usually where the causes arise in women who are suffering from pelvic pain. Both men and women can suffer from pelvic pain, but it is most common in women and can happen at any age.

Causes for pelvic pain within the female reproductive system include:

• Adenomyosis
• Ectopic pregnancy
• Endometriosis
• Menstrual cramps
• Miscarriage
• Mittelschmerz (ovulation pain)
• Ovarian cancer
• Ovarian cysts
• Pelvic inflammatory disease (PID)
• Salpingitis (inflammation of the fallopian tubes)
• Uterine fibroids
• Vulvodynia

Causes that can make pelvic pain arise in both women and men include:

• Appendicitis
• Crohn’s disease
• Chronic constipation
• Colon cancer
• Diverticulitis
• Intestinal obstruction
• Fibromyalgia
• Kidney stones
• Muscle spasms

If severe pelvic pain develops rapidly, it may be a medical emergency that you need to seek treatment for immediately. Be seen by a doctor if your pelvic pain is worsening and interrupting your daily life.

Diagnosis and Treatment of Pelvic Pain

Based on your symptoms including the pelvic pain, your doctor will want to run a few tests in order to give you a correct diagnosis and treat you promptly. In order to figure out the cause of the pain, it will boil down to a process of elimination by your doctor. You will be interviewed about your pain and your medical history, including any past or recent traumas to the area.

Some tests that may help your doctor diagnose you may include:

• Pelvic exams can help discover if there are any abnormal growths, spots of tenderness, tense pelvic floor muscles, or signs of infection.
• Lab tests will uncover if there are any traces of infection in your blood. A blood test will also show the doctor your full blood cell count, and your doctor may order a urinalysis to check for a urinary tract infection.
• Ultrasounds may be ordered if your doctor finds it necessary to confirm a mass or cysts in the ovaries, fallopian tubes, or uterus.
• MRI or X-rays can determine if you have any abnormal growths or structures.
• A Laparoscopy helps your doctor view the organs around your pelvis by making a small incision in the abdomen and inserting a small camera. This procedure will check for signs of infection or abnormal tissues. If endometriosis or chronic pelvic inflammatory disease is determined, a laparoscopy is crucial in identification.

Diagnosing pelvic pain can be a long and tiring process, and the cause may not even be discovered. With that being said, it is still very important to tell your doctor about your symptoms so that a treatment plan can be conducted.

Your doctor may want to reduce your discomfort and pain as much as possible with the use of medications such as pain relievers, hormone treatments, antibiotics, and/or antidepressants. Other types of therapy can include physical therapy, neurostimulation (spinal cord stimulation), trigger point injections, or psychotherapy if the pain is a cause of past trauma from sexual abuse, crisis, or depression.