Pelvic Pain

Pelvic pain is pain that occurs in the lower abdomen and pelvis.

The pelvic region is the area between the umbilicus (belly button) and the groin in the front and between the buttocks at the back. Pelvic area mainly consists of reproductive, urinary and digestive systems such as uterus, bladder and intestines.

Pelvic pain can be acute or chronic. Acute pelvic pain occurs suddenly and stays only for a short period of time.  Chronic pelvic pain lasts for more than six months and does not show any improvement with treatment.

Symptoms of Pelvic Pain

Pelvic pain may be dull or sharp; persistent or intermittent; mild to severe, and can extend to your lower back or thighs.

The common symptoms with pelvic pain are:

  • Pain in the hip and groin area

  • Pain and cramps during menstruation

  • Pain during urination, bowel movements, and intercourse

  • Fever or chills

  • Constipation or diarrhea

Causes of Pelvic Pain

Usually, pelvic pain is considered as an indication for infection or problem in the pelvic area. It is observed most commonly in women but can also occur in men.

The common causes of acute pelvic pain are:

  • Pelvic inflammatory disease (infection of the reproductive organs),

  • Urinary tract infection

  • Appendicitis (inflammation of appendix)

  • Ectopic pregnancy (pregnancy that occurs outside the uterus)

  • Twisted or ruptured ovarian cyst

  • Ruptured fallopian tube

  • Miscarriage or threatened miscarriage

  • Congestion or abscess (collection of pus) in the pelvic region

The common causes of chronic pelvic pain are:

Chronic pelvic inflammatory disease

  • Endometriosis (abnormal growth of uterus lining)

  • Interstitial cystitis (inflammation of urinary bladder)

  • Irritable bowel syndrome

  • Pelvic floor disorders (spasm or tension in the pelvic floor muscles)

  • Uterine fibroids (non-cancerous uterine growths)

  • Psychological factors such as stress, depression or a history of physical abuse

Diagnosis of Pelvic Pain

Your physician diagnoses pelvic pain by observing your pain symptoms, medical history, and by performing a pelvic examination.

For additional information, your physician may request

  • blood tests,

  • urine and culture test, pregnancy test, and

  • imaging studies.

The imaging studies such as X-ray, ultrasound, laparoscopy, CT (Contrast tomography) and Magnetic resonance imaging (MRI) scan are helpful in examining the pain source in the pelvic region.

Treatment of Pelvic Pain

Treatment for pelvic pain depends on the cause of pain, intensity and frequency of the pain.

Conservative management of pelvic pain includes

  • rest and

  • participating in regular physical therapy and

  • exercise.

Medication can be used to relieve

  • pain (pain killers),

  • muscle spasm/ contraction (muscle relaxants) and

  • to treat infection (antibiotics).

Dr Alexander may also instruct you to take hormonal medications for pain relief during ovulation and menstruation.

Surgery is considered for patients with chronic pelvic pain due to

  • endometriosis,

  • pelvic floor disorder, and

  • other chronic pelvic problems.

Laparoscopic surgery (removal of endometrial tissue or pelvic adhesion) and hysterectomy (removal of uterus) are the common surgical options for treating pelvic pain.