Definition & Overview

As the name implies, pelvic pain is any pain felt in an individual’s pelvic area. There are two basic types of pelvic pain: acute and chronic. Acute pelvic pain is often severe but does not last for long. If an individual feels pain in the pelvic area for more than six months, the condition can be referred to as chronic pelvic pain.

The pelvic area is located in the lower part of the abdomen, and pelvic pain can involve problems in the pelvic bone or the internal reproductive organs of an individual, most particularly women. Female patients who are suffering from pelvic pain often have problems in their vagina, cervix, fallopian tubes, uterus, or ovaries.

Cause of condition

Pelvic pain can be caused by a wide variety of conditions and problems. In female patients, pelvic pain is one of the symptoms of endometriosis, an immune and hormonal disease that leads to cells similar to those in the endometrium (the lining of the uterus) thriving outside the uterine cavity, often in the peritoneum, or the lining of the abdominal cavity. Endometriosis can result to not only pelvic pain (which can be felt at its worst during the menstrual cycle), but also infertility.

In both male and female patients, bowel adhesions, irritable bowel syndrome, and interstitial cystitis (or the chronic inflammation of the membranes and muscles of the bladder) can cause severe pain in the pelvic area.

Many women suffer from pelvic pain because of pregnancy and other gynaecological conditions. Pelvic girdle pain, often occurring in pregnant women, can cause not only pain in the pelvic area, but also limited function and mobility in one or more of the three pelvic joints. Pudendal nerve entrapment, or the entrapment or compression of the pudendal nerve in the pelvis, is more uncommon source of chronic pelvic pain. Because the nerve is trapped in the pelvis, certain positions worsen the pain, including sitting. Some sufferers of pudendal nerve entrapment report numbness in the genitals, as well as incontinence of both feces and urine.

Gynecological conditions of female patients resulting to acute or chronic pelvic pain also include dysmenorrhea (pelvic pain when menstruating), infection in the reproductive organs, ovarian cysts, ectopic pregnancy (pregnancy occurring outside the uterus), ovarian torsion, and abnormalities of the Mullerian ducts.

Pelvic pain can also be caused by abdominal conditions such as colitis (the inflammation or infection of the colon), proctitis (the inflammation or infection of the rectum or anus), and appendicitis (inflammation or infection of the bowels). A strangulated hernia can also cause pelvic pain.

Pelvic pain can be a symptom of muscle and bone problems—if one is suffering from conditions in the pelvic bones, hip joints, and lower back, one can feel acute or chronic pain in the pelvic area.

Key symptoms

Symptoms can vary, and they all depend on the cause of the pain. Endometriosis is often accompanied by symptoms such as pelvic pain during ovulation, cramps before or during a menstrual period, pelvic pain during or after intercourse, pain when defecating, bleeding in the rectum during menstrual periods, pain when urinating, pain in the lower back, and abdominal bloating.

When the pain in the pelvic area is accompanied by one or more of the following symptoms, you should consult your doctor as soon as possible.

  • Menstrual cramps
  • Bleeding, abnormal discharge, and spotting in between menstrual periods
  • Difficulty or pain when urinating
  • Diarrhea or constipation
  • Bloody stools
  • Pain during or after intercourse
  • Fever
  • Chills
  • Pain in the hips
  • Bloating
  • Excessive gas
  • Pain in the groin

Who to See & Types of Treatments Available

The causes of pelvic pain vary widely, and the cause has to be identified before treatment can be prescribed. If you are suffering from acute or chronic pelvic pain, its best to consult a general physician first who can prescribe the following tests:

  • Urine tests
  • Blood tests
  • Pregnancy tests
  • STD tests
  • X-rays of the pelvic and abdominal area
  • Diagnostic laparoscopy
  • Bone density screening
  • Hysteroscopy
  • CT scan of the pelvic and abdominal area
  • Ultrasound

Once these tests point to an illness, inflammation, infection, or any abnormal condition, you can consult and seek treatment from a specialist. Women suffering from gynaecological problems leading to pelvic pain can consult a gynaecologist. On the other hand, those suffering from a bladder problem can go straight to a urologist, especially in the case of interstitial cystitis and bladder infections. However, if a problem in the digestive system is causing the pelvic pain, one can go to a gastroenterologist. A doctor specializing in gastroenterology can provide treatment for irritable bowel syndrome and other such conditions. A specialist in internal medicine can also be qualified to diagnose and treat conditions that lead to pelvic pain.

A pain specialist, on the other hand, can help in managing the pain when it comes to those suffering from chronic pelvic pain. A medical professional specializing in pain management can prescribe nerve blockers, stimulation of the nerves or medication for effective pain management.

Muscle and bone problems in the pelvic area can also be addressed by a physical therapist who can design an exercise or relaxation program that will keep the pain under the patient’s control.

Again, the treatment for pelvic pain varies and heavily depends on what is causing the pain. There are times when a medical professional can prescribe pain medication for effective pain management, especially in the case of unexplained acute pelvic pain. Medication can also be prescribed to manage the other symptoms accompanying the pain. In the case of infections in the gastrointestinal tract, bladder, and reproductive organs, a medical professional can prescribe antibiotics that will manage the infection. However, if the cause of the pelvic pain is serious and can be threatening to the patient’s future health, surgery can be recommended.

References:

  • Understanding Chronic Pelvic Pain, Pelviperineology
  • Chronic Pelvic Pain in Women, American Family Physician
  • Best Practice and Research: Clinical Obstetrics and Gynaecology
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