What is pelvic pain?
Pelvic pain is a general term that health care providers use to describe pain that occurs mostly or only in the lower abdomen area. It may be steady pain, or pain that comes and goes. In some cases the pain may be severe and might get in the way of daily activities. In other cases, the pain might be dull and occur only during the menstrual cycle. Pelvic pain also describes pain that occurs during sexual intercourse.
What Causes Pelvic Pain?
In general, pelvic pain signals that there might be a problem with one of the organs in your pelvic area: uterus, ovaries, fallopian tubes, cervix, vagina, urinary tract, lower intestines, or rectum. Or the pain might be a symptom of infection. Sometimes pelvic pain can be caused by muscular and skeletal problems. There are some common health conditions that are often associated with pelvic pain, including:
- Vulvodynia – describes chronic pain or discomfort of the vulva (the external female genitalia). Vulvodynia can cause burning, stinging, irritation, or rawness of the vulva. The type of pain can be different for each woman. Pain may move around or always be in the same place. It can be constant, or come and go.
- Endometriosis – occurs when tissues that usually line a woman’s uterus instead grow outside the uterus. These tissues often grow on the surfaces of organs in the pelvis or abdomen, where they are not supposed to grow. The two most common symptoms of endometriosis are pain and infertility.
- Uterine Fibroids – are the most common, non-cancerous tumors in women of childbearing age. The fibroids are made of muscle cells and other tissues that grow within and around the wall of the uterus. Symptoms can include heavy or painful periods, pain during sex, and lower back pain, among others.
Possible causes of pelvic pain in both men and women may also include:
- Bladder disorders
- Sexually transmitted diseases
- Kidney infection or kidney stones
- Intestinal disorders
- Nerve conditions
- Hernia
- Pelvis disorder
- Broken pelvis
- Psychogenic pain
- Appendicitis
Possible causes of pelvic pain in women only may include:
- Ectopic pregnancy
- Miscarriage
- Pelvic inflammatory disease
- Ovulation
- Menstrual cramps
- Ovarian cysts or other ovarian disorders
- Fibroids
- Endometriosis
- Uterine cancer
- Cervical cancer
What Symptoms Suggest a Problem?
- Menstrual cramps
- Menstrual pain
- Vaginal bleeding, spotting or discharge
- Painful or difficult urination
- Constipation or diarrhea
- Bloating or gas
- Blood seen with a bowel movement
- Pain during intercourse
- Fever or chills
- Pain in the hip area
- Pain in the groin area
Pelvic Pain Diagnosis
To determine what is causing pelvic pain, your doctor will first ask you several questions about your symptoms and past medical problems. He or she will also perform a physical exam and may offer you tests to determine what is causing your pain. Other tests that may be given include:
- Blood and urine tests
- Pregnancy tests in females of reproductive age
- Vaginal or penile cultures to check for sexually transmitted diseases such as gonorrhea and/or Chlamydia
- Abdominal and pelvic X-rays
- Bone density screening (special type of X-ray to determine the strength of bone)
- Diagnostic laparoscopy (procedure allowing a direct look at the structures in the pelvis and abdomen)
- Hysteroscopy (procedure to examine the uterus)
- Stool guaiac test (checking a stool sample for presence of microscopic blood)
- Lower endoscopy (insertion of a lighted tube to examine the inside of the rectum and part or all of the colon)
- Ultrasound (test that uses sound waves to provide images of internal organs)
- CT scan of the abdomen and pelvis (scan that uses X-rays and computers to produce an image of a cross-section of the body)
