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Overview of Pelvic Pain: Definition, symptoms, causes & treatment

Team AckoSept 21, 2023

Pelvic Pain is a distressing experience for many people. It can disrupt your daily routine, affect work, and even lead to emotional stress. The pelvis is the area below the abdomen that lies between the hip bones. Any pain in the area of the pelvis is referred to as Pelvic Pain (PP). Although most people immediately think of gynaecological issues in this context, there can be a lot of other causes of PP. It can affect people of all sexes, and this can be due to a wide variety of causes.

Contents

Causes of Pelvic Pain
- Gynaecological causes of Pelvic Pain
- 2. Non-gynecological causes of Pelvic Pain
What are the symptoms of Pelvic Pain?
How is Pelvic Pain diagnosed?
What is the treatment for Pelvic Pain?
Frequently Asked Questions

Causes of Pelvic Pain

The causes of PP can be broadly differentiated into two categories: gynaecological and non-gynecological. Let us look at some of the most common causes in each category briefly.

Gynaecological causes of Pelvic Pain

The female reproductive organs are primarily housed within the bony pelvis. They include the uterus, the ovaries, the fallopian tubes, the cervix and the vagina. Here are some of the common causes of PP that occur due to some issue in the female reproductive organs.

1. Menstrual cramps/Dysmenorrhea

Most women have experienced cramps in the pelvic area that begin a few days before the period and worsen when they begin to bleed. These cramps can range in severity from mildly annoying to debilitating, associated with nausea and loss of appetite. Certain medical conditions worsen this period of pain, such as.

Fibroids: These are benign growths in the uterus that can be single or multiple and can cause pain or bleeding difficulties.
Endometriosis: The endometrium is the innermost lining of the uterus which is shed during the period. When endometrial tissue grows in places outside of its normal position it is known as endometriosis. Just as your endometrium bleeds and sheds during your period, these sites undergo the same hormonal stimulation causing severe pain.
Adenomyosis: Adenomyosis is the condition where the endometrial tissue grows in the muscle layer of the uterus. It can cause enlargement of the uterus, severe PP, and excessive bleeding.

These conditions are primarily treated with hormonal therapies, and may sometimes require surgical intervention. Mild PP may be experienced in the middle of the cycle at the time of ovulation as well.

2. Pelvic Inflammatory Disease

This is an infectious condition that, if left untreated, can result in chronic, nagging pain and infertility.

3. Ovarian cysts

Ovarian cysts are a common asymptomatic condition and usually resolve by themselves. However, a large cyst can cause symptoms like dull aching Pelvic Pain, lower abdominal heaviness, and bloating.

4. Conditions related to pregnancy

Miscarriage: Pregnancy loss presents with vaginal bleeding and acute PP.
Ectopic pregnancy: Pregnancy that occurs outside of the uterus can rupture resulting in pain.
Cancers: Cancers affecting different structures of the female reproductive tract may sometimes present with PP. Associated symptoms may include abnormal vaginal bleeding, discharge from the vagina, swelling in the lower abdomen, weight loss, poor general condition, urinary and bowel issues, etc.

2. Non-gynecological causes of Pelvic Pain

Some non-gynecological causes that can result in Pelvic Pain include chronic constipation, kidney stones, appendicitis, urinary tract infections, and inflammatory conditions of the intestine such as Crohn’s disease or ulcerative colitis.

What are the symptoms of Pelvic Pain?

The symptoms of Pelvic Pain vary depending on the underlying cause. However, some common symptoms include the following.

Pain in the lower abdomen or pelvis
Pain during intercourse
Painful menstrual periods
Pain while urinating or passing stools
Abdominal bloating or swelling
Nausea and vomiting
Fatigue or weakness
Fever or chills

How is Pelvic Pain diagnosed?

The process of diagnosing the exact cause of Pelvic Pain can be tedious. Doctors usually begin with a clinical pelvic examination to check for pain. Laboratory tests to check for infection, inflammatory markers, or STIs may be advised. An ultrasound is a valuable tool for detecting any mass in the region. A CT scan or MRI may also help in this regard. For conditions such as endometriosis, directly visualising the lesions using laparoscopy is the gold standard for diagnosis.

What is the treatment for Pelvic Pain?

The treatment of Pelvic Pain will depend on the underlying cause and may involve a combination of lifestyle changes, medications, and other interventions.

1. Lifestyle changes

Upgrading to a healthier lifestyle has numerous benefits. One among these is reduced PP. Changes include the following.

Eating a healthy, well-balanced diet that includes plenty of fruits, vegetables, and whole grains
Reducing stress through relaxation techniques such as meditation or deep breathing exercises
Increasing physical activity through exercise or physical therapy
Maintaining a healthy weight
Avoiding tobacco and excessive alcohol consumption.

2. Medications

Over-the-counter pain relievers such as paracetamol or ibuprofen may be helpful in managing mild to moderate Pelvic Pain. For more severe pain, prescription medications such as opioids or nerve blocks may be necessary.

In cases where Pelvic Pain is caused by a specific condition, such as endometriosis, hormonal therapy may be prescribed. Hormonal therapy helps reduce pain by suppressing the production of hormones that contribute to the growth of endometrial tissue.

3. Other Interventions

In some cases, more invasive interventions may be necessary to treat Pelvic Pain. These may include the following.

Surgery: In cases where PP is caused by conditions such as endometriosis or fibroids, surgery may be necessary to remove the affected tissue.
Physical therapy: Pelvic floor physical therapy can be helpful in relieving PP by strengthening the muscles of the pelvic floor and improving circulation in the area.
Nerve blocks: Nerve blocks involve injecting medication into the nerves that are causing pain, effectively blocking the transmission of pain signals. Your doctor is the best person to decide which is the best treatment for you depending on the underlying issue. These treatment measures can be used individually or in combination with varying efficacy.

Frequently Asked Questions

Here’s a list of common questions and answers related to Pelvic Pain.

I have very severe menstrual cramps that don’t go away even after taking medicine. What could be the cause?

Conditions such as endometriosis and adenomyosis can cause severe, debilitating period pain that does not respond to painkillers. It is best to visit a gynaecologist for the treatment of severe menstrual cramps and pain.

I recently started getting vaginal bleeding after 5 years of menopause with mild pain. What should I do?

Any bleeding in postmenopausal women warrants immediate medical attention as it could be one of the first signs of serious underlying conditions. Associated pain, vaginal discharge, and weight loss could indicate cancer of the female reproductive tract.

Can men get Pelvic Pain?

The urinary bladder and the lower part of the digestive tract are also located in the pelvis and any disease of these organs can cause Pelvic Pain in men as well.

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. Please consult a doctor before making any health-related decisions. Pelvic Pain is written as PP in this article.