Pelvic pain is a symptom most commonly associated with women's health, from endometriosis or fibroids to more serious conditions, such as an ectopic pregnancy or cancer. However, there are many other causes, including appendicitis and kidney stones, and men can experience them just like women. Other causes of pelvic pain occur exclusively in men.
Pelvic pain is often described as a dull ache or pressure that may or may not include sharp pains anywhere in the abdomen below the navel. The pain may be intermittent or persistent and may be accompanied by other symptoms such as abnormal vaginal bleeding or discharge and low back pain.
Multiple systems can cause pelvic pain, including:
- Reproductive system (both female and male)
- Gastrointestinal system
- Musculoskeletal system
- Urinary tract system
Female reproductive system
Many different conditions that affect the female reproductive system can cause pelvic pain, including:
- Ectopic pregnancy : The embryo implants in the fallopian tube instead of the uterus, often causing vaginal bleeding. A ruptured fallopian tube is a life-threatening situation that can cause severe pain, drop in blood pressure, fainting, and shock.
- Pelvic inflammatory disease : This condition is an infection of the uterus, ovaries, fallopian tubes, and vagina, usually caused by sexually transmitted infections such as gonorrhea or chlamydia. Pelvic pain can be worse during sex. Abscesses can develop causing severe pelvic pain and fever.
- Endometriosis : Tissue normally found in the lining of the uterus grows in the ovaries, fallopian tubes, or intestines, causing pelvic pain during menstruation and sex, and sometimes when urinating or having a bowel movement.
- Uterine fibroids : Benign pelvic tumors in the uterus can cause heavy and / or prolonged periods and pelvic discomfort, often described as pressure or dull pain.
- Mittelschmerz pain: Mild unilateral pelvic pain can occur when an egg is released from the ovary. If the pain is severe, it could be a sign of endometriosis.
- Ruptured Ovarian Cyst – A ruptured cyst may not cause any symptoms or be associated with one-sided pelvic pain, often described as sudden, sharp pain that begins after sexual intercourse or physical activity.
- Ovarian torsion – The ligaments that hold the ovary in place twist and twist, blocking the blood supply to the ovaries and causing sudden and severe pelvic pain that can be sharp, dull, or spasmodic and radiate to the lower back or groin . It can also cause a low-grade fever, nausea, and vomiting.
First aid: ovarian torsion
Ovarian torsion is sometimes confused with cyst rupture, but this is an important distinction because ovarian torsion is an emergency and requires immediate surgery.
Pelvic pain can be a symptom of most gynecological cancers , although it usually only appears as the cancer progresses. While the symptoms may be similar, the different forms have some key differences.
- Ovarian Cancer : Unlike other gynecologic cancers, pelvic pain can be an early sign of ovarian cancer. along with symptoms like bloating, back pain, and gastrointestinal changes like constipation.
- Endometrial cancer : pelvic pain can appear later. This cancer is also associated with abnormal vaginal bleeding , such as bleeding after menopause or spotting between periods.
- Cervical Cancer : Abnormal vaginal bleeding, including bleeding after intercourse, can be a symptom of cervical cancer, with pelvic pain later on.
Male reproductive system
The reproductive causes of pelvic pain in men are mainly due to the prostate, which is a small gland that produces semen.
- Prostatitis – Inflammation causes swelling of the prostate and sometimes surrounding areas, leading to pelvic pain and painful or difficult urination.
- Prostate Cancer : Pelvic pain is rare until the cancer progresses. Earlier pain may be associated with the spread of cancer to the bones.
Several different conditions that affect the intestines, especially the colon (colon), can cause pain in the lower abdomen that can feel like it is in the pelvis.
- Appendicitis : Inflammation of the appendix causes sudden pain near the navel that travels to the lower right part of the abdomen (so it can be mistaken for pelvic pain). Other symptoms include loss of appetite, fever, vomiting, and pain when moving. Appendicitis requires immediate medical attention.
- Irritable Bowel Syndrome : This functional gastrointestinal disorder causes abdominal cramps that can be aggravated by stress or food intake. The pain can be relieved with a bowel movement. Other symptoms include bloating, diarrhea, and / or constipation.
- Diverticulitis : infection or inflammation that develops in the wall of the colon.
- Constipation : Infrequent bowel movements (less than two or three times a week) can cause abdominal discomfort.
The pelvis is a complex bony structure made up of many muscles, ligaments, and tendons. Due to this number of elements, there is the possibility of various problems with the musculoskeletal system that can cause pain in the pelvic region. Here are two examples:
- Non-relaxing pelvic floor dysfunction – Pelvic muscles do not relax or contract properly, leading to pelvic pain and problems with sexual function, urination, and bowel movements.
- Iliac crest pain syndrome : pain along the curved upper part of the ilium (the largest bone in the pelvis) may be due to weakness of the muscles in the back, hip, and abdomen, or inflammation of the tendons and ligaments in that area.
Urinary tract system
The two most likely sources of pelvic pain in the urinary tract are kidney stones and infections.
- Kidney stones : Minerals in urine build up and form crystals. If the stone is large enough to lodge in the urinary tract system, it can cause severe pain. more blood in the urine, nausea and vomiting.
- Urinary tract infection : Symptoms include bladder pain and frequent urination, burning when urinating, the urge to urinate, and blood in the urine.
UTI in the elderly
In older people, the symptoms of a urinary tract infection may be less obvious, for example:
- General discomfort
- Soft spot
- Urinary incontinence
- The fall
- Behavior changes
When to contact a healthcare provider
If you experience sudden severe pelvic pain, seek medical attention immediately. Three possible causes (appendicitis, ectopic pregnancy, and ovarian torsion) are life-threatening conditions that require immediate surgery.
If you experience persistent or prolonged pelvic pain, it should be evaluated by a doctor so that it can be properly diagnosed and treated. Many causes of pelvic pain can become serious if left untreated.
For those who are menstruating, it is important to note that mild cramps and pain associated with menstruation are normal and do not require medical attention unless you are in severe pain (a condition called dysmenorrhea ).
Seek emergency care for sudden, severe pelvic pain, especially if it is unilateral or if you are pregnant.
To help your healthcare provider accurately diagnose the cause of your pelvic pain, try writing down information such as when the pain occurs, what it does, when it occurs, and what helps relieve it.
After all, creating a symptom / pain log is a great way to keep track of your pain and can make the first step in the diagnosis process – your medical history – that much more effective.
History of the disease
When you see your doctor about pelvic pain, be prepared to answer questions about when the pain occurs, what causes it, what relieves it, and how long you've been experiencing it. Also, during your medical history, your healthcare provider may ask you questions about your family, such as whether you have a family history of fibroids or cancer.
Your healthcare provider will also take a gender history to find out how many sexual partners you have and if you have ever had a sexually transmitted infection .
When evaluating pelvic pain, a key part of the physical exam is a pelvic exam, in which your healthcare provider looks for abnormalities (such as tenderness or growths) in your reproductive system.
Because pelvic pain can be related to organs other than the reproductive system, your healthcare provider will likely also examine your abdomen and lower back to determine the source of your intestinal or kidney pain.
Based on the results of your medical history and pelvic / physical exam, your healthcare provider may want to perform additional tests to determine the cause of your pelvic pain. If you are able to get pregnant, this will likely be one of the first tests your healthcare provider will order.
Other tests that can be done include:
- Colonoscopy to look for masses, obstructions, or abnormalities in the intestines.
- A sigmoidoscopy to examine the lower part of the colon for causes of pain, bleeding, and bowel changes.
- Urinalysis for urinary tract infections and kidney problems
- Pelvic exam and vaginal swabs to check for infections (and Pap smear if needed to check for cervical cancer).
Depending on the suspected cause of your pelvic pain, an imaging test may be done. Ultrasound is often the first imaging test used to evaluate pelvic pain, but other tests may include computed tomography (CT). abdominal cavity and pelvis or ultrasound of the pelvic organs.
There are many treatments for pelvic pain, and the exact treatment depends on the underlying cause. For example, urinary tract infections are treated with antibiotics and surgery is needed to treat urgent causes such as an ectopic pregnancy, ovarian torsion, or appendicitis.
Surgery is also often the first-line therapy for certain cancers and is used to treat severe cases of endometriosis and fibroids.
Frequently asked questions
What Causes Pelvic Pain During Pregnancy?
If you are pregnant and have severe pressure or pelvic pain accompanied by lower back and abdominal pain, this could be a sign of labor and you should call your doctor. However, if it is in the second trimester, it can also be round ligament pain , which occurs when the ligament that runs from the groin to the uterus is stretched.
What treatment options are available for pelvic pain?
Treatment for pelvic pain depends on the cause. Pain relievers and muscle relaxants can be helpful for certain causes of pelvic pain, and hormone therapy can be used for conditions like endometriosis. Physical therapy and pelvic floor exercises can help strengthen your pelvic muscles and relieve pain.
Get the word of drug information
Pelvic pain is physically and emotionally distressing, and for all possible reasons, you may be concerned that it is something serious. Talk to your doctor, give him as much information as possible about your pain, and expect him to run a series of tests to find out what's causing it. And remember that sudden severe pelvic pain requires a visit to the emergency room.