Your Pelvic pain can result from surrounding pelvic bones, infection in the pelvic area or issues in reproductive organs.
The Pelvis or pelvic area is in the middle of the legs and the abdomen, it is the lower part of the torso in a female body. The pelvic region consists of the bladder, male and female reproductive system (uterus, ovaries), rectum and colon.
The uterus is also considered a part of the pelvis. Usually felt under the navel, this pain affects women as well as men. However, pelvic pain in women is more common than men.
This article will highlight:
- Causes of Pelvic Pain
- Symptoms of Pelvic Pain
- Treatment of Pelvic Pain
Causes and Types of Pelvic Pain
Pelvic pain can either be acute or chronic. Acute pain is the unexpected and sudden pain that you feel under your belly button whereas chronic pain is long-term and persists for more than 6 months.
The Causes of the Acute Pelvic Pain are:
- The rupture of an ovarian cyst: Ovarian cysts are benign and have no symptoms, however, when this fluid-filled sac formed in the ovary ruptures or twists then it does cause pelvic pain and irregular bleeding.
- Appendicitis: The appendix can be removed if it gets infected. Appendicitis causes pelvic pain on the right side along with nausea and fever. Surgery is done to remove the appendix.
- Peritonitis: Not removing the appendix timely can cause life-threatening peritonitis. It is caused by the inflammation of the inner layer of tissue of the abdomen leading to acute pelvic pain and abdominal pain, and it should be taken care of immediately.
- Urinary Tract infection (UTI): Besides creating an urge to urinate, UTI also causes pelvic pain and a burning sensation when urinating.
- Constipation: This too can cause pelvic pain which can be a result of Irritable Bowel Syndrome, changes in diet or lactose intolerance.
- Pelvic Abscess: Immediate treatment is required when pus accumulates between womb and vagina.
- Mittelschmerz: This short-term pain can last from minutes to hours and it occurs when ovulation happens. The pain occurs when the membrane stretches to release the egg.
The Causes of Chronic Pelvic Pain:
- Pelvic Inflammatory Disease: PID occurs from germs entering the womb through the vagina and can later even lead to infertility if left untreated. PID can cause infection in the uterus and fallopian tubes and the pelvic pain in this case acts as a symptom of PID.
- Endometriosis: In endometriosis, the tissue from your uterus lining starts growing outside the uterus which essentially means that this tissue breaks down in your menstrual cycle but does not leave your body through your vagina as the rest of your period, thus only causing pelvic pain. In certain cases, endometriosis may also interfere with conceiving.
- Irritable Bowel Syndrome: Long-term diarrhea, cramps and constipation that are on and off can happen because of the gut disease IBS.
- Fibroids: These benign tumors around the womb, when twisted or destroyed can cause this issue.
- Interstitial cystitis: The painful bladder syndrome leads to pain in the pelvic region when the bladder fills up and you feel a constant urgent need to urinate.
- Musculoskeletal problems: Bones and tissues affected in this system due to issues like hernia or pelvic floor tension can lead to this problem.
- Adenomyosis: This is a type of endometriosis that affects the tissues of the womb, hence the pain results from endometrial glands during periods.
- Damaged nerves in the pelvis: These pains can cause a sharp pain in one area and can get more painful with movement.
- Ovary remnant: Following surgery of removal of a reproductive organ, an ovary may still accidentally remain and grow to become a pain-inducing cyst.
- Adhesions: When the body is healing after a surgical procedure, certain tissues might stick together to induce pain more likely in the bowel.
- Premenstrual Syndrome (PMS): Having longer days of pain in the pelvic and non-pelvic region like the head and back before the menstruation period starts.
- Period Pain: Likewise it also happens in women when they have menstrual cramps. Most women may not feel strong pain in their periods but about 1 in 10 women do undergo severe periods of painful pain.
- Lower back and bone pain: If there are any issues in hip joints, lower back pain, or some problem in your bones then it is also likely to cause pelvic pain.
- Pelvic Organ Prolapse: This term condition arises when the womb lowers down from its original position and protrudes in the vagina. It mostly affects women of an older age.
- Pregnancy: This pain occurs in a woman when she is pregnant because the baby in the womb grows to push itself in the pelvis. Likewise, other organs also rearrange themselves, resulting in pelvic pain. Ectopic pregnancy may also cause pain.
- Psychological factors: Depression or emotional distress can increase this issue and vice versa, the chronic pain can increase distress.
Symptoms of Pelvic Pain
Pelvic pain may occur in more than one specific part. You may be able to point it towards your entire pelvis. You may undergo sharp pains and cramps or very light aches.
The pain may be irregular that comes and goes or also steady and severe. Your body may also feel heaviness in your pelvic region below your belly button.
You can detect the symptoms of pelvic pain if you notice that you are experiencing pain while having sexual intercourse.
If there is excessive vaginal bleeding during your menstrual cycle and if you are having pain in the hip and groin area then these signs point towards pelvic pain. You may also notice increased pain while urinating or having constant diarrhea and constipation.
A constant lower back pain, nausea and vomiting are also symptoms of developing pelvic pain.
Diagnosis of Pelvic Pain
Pelvic Pain can be caused by more than one reason, it is reasonable to eliminate all options one by one to come to the real cause of the pain.
Your doctor may conduct physical exams to determine the origin of the pain and gather some health information.
You first undergo a pelvic exam to find out the pain regions. This can highlight if there are some infections as the doctor will search for areas where you will feel pain.
If needed, the doctor will also conduct some lab tests to check for STIs like gonorrhea and carry out urinalysis to guarantee that UTI is the cause or not.
You may get an MTI scan to get a closer look at cysts. Also a, CT scan to check for abnormalities in the colon or diverticular disease.
A laparoscopy can be conducted by the doctor if the pain is persistent and the other tests have not identified the cause.
This is a surgical procedure that allows the doctor to make an incision in the abdomen. Then inserting a tube with a small camera to observe the pelvis and the abdomen. Hence detecting problematic infections or abnormalities.
Laparoscopy is especially effective in detecting endometriosis and adhesions.
Your doctor may conduct, cystoscopy to examine the bladder and find interstitial cystitis and colonoscopy to identify inflammatory bowel disease.
Other than this, your doctor can also conduct bone density screening to identify the strength of your bones. A stool test, besides the very important urine test, will be carried out. To examine the colon and inside of rectum a lower endoscopy can be conducted.
Your doctor will most probably carry out a blood test and a vaginal culture to confirm or rule out the presence of STD’s.
Treatment of Pelvic Pain
Since Pelvic Pain occurs more as a symptom of some other problem, your doctor’s treatment would include reducing the pain and pain management.
You can cure this by using medicines, carrying out surgery or therapy.
Medicines for Pelvic Pain
Painkillers, pain medications and over the counter medicines can provide temporary relief.
If your pelvic pain is due to menstrual cramps then they can be quite useful in eliminating the pain. Along with birth control pills but otherwise, medicines like Ibuprofen and aspirin can give small-term relief.
If the cause of your pain is due to an infection, then you will be prescribed antibiotics to get treated.
Broad-spectrum and oral antibiotics are used to cure both Pelvic Inflammatory Disease and Urinary Tract Infection. In extreme cases, IV antibiotic treatment may be required to treat you.
Moreover, tricyclic antidepressants are found to have pain-relieving as well as anti depressing qualities for your pain.
In some cases, taking antidepressants can help reduce chronic pelvic pain.
Therapy for Pelvic Pain
Physical Therapy will help in stretching exercises and muscle movement. A physical therapist may identify the points of your pain and suggest coping mechanisms and exercises for that specific point.
Another technique used for therapy can be neurostimulation that helps block the signals of pain to the brain.
Your doctor can also inject you on specific points if your pain points are identifiable. These trigger point injections can numb that painful area, therefore, providing some relief.
it is more beneficial to take psychotherapy such as cognitive behavior therapy.
Surgery for Pelvic Pain
A surgery might involve the removal of the problem causing part which in some cases becomes the uterus. Endometriosis requires laparoscopy to detect it and remove the uterus if the woman does not intend to have more children.
Surgical procedures like hysterectomy and myomectomy remove your uterus and fibroids respectively.
Surgery can remove your pelvic and ovary mass depending on the size of the mass and your age.
The doctor’s treatments are hard to be satisfied with initially. Since, to understand the cause a long and tedious process is required.
Hence, detecting and treating pelvic pain requires patience. Pain killers can be effective in temporarily giving you relief. However, if you will cooperate with the doctor, this pain can be removed effectively permanently.