Pelvic pain is pain that affects the lower part of the abdomen (the area between the belly button and groin). Pelvic pain is a general symptom resulting from multiple causes, from menstrual cramps to a ruptured ovarian cyst. Due to the various causes of pelvic pain, evaluation is warranted.
What is considered pelvic pain?
Pelvic pain is a broad term that can encompass pain in many different parts of your body. Pelvic pain may encompass sharp pain, intermittent pain or chronic pain in any of the following areas:
- Lower abdomen (anywhere from the belly button to the groin)
- Uterus
- Ovaries
- Cervix
- Vagina
- Or anywhere else in the area of the pelvis
Types of pelvic pain
- Sudden onset pelvic pain that is sharp or stabbing
Extreme pain in the pelvic area that comes on suddenly requires urgent medical attention. Pelvic pain that is sudden and severe may be a sign of a ruptured ovarian cyst, an ectopic pregnancy or an infection. All of these medical conditions must be treated urgently at a hospital or medical clinic. - Pelvic or abdominal pain that is constant
Pelvic pain that lingers around for weeks or months should always be investigated. Conditions such as endometriosis, fibroids or pelvic inflammatory disease (PID) may cause this type of pain. Other causes include endometrial polyps or cancers of the reproductive tract.
Common causes of pelvic pain
- Fibroids
- Endometriosis
- Pelvic inflammatory disease
- Ovarian cysts
- Functional cysts
- Urinary tract infections
- Constipation or Irritable Bowel Syndrome (IBS)
- Sexually Transmitted Infections (STIs)
While many causes of pelvic pain are not serious, it’s important to be aware of a few conditions that cause dull, constant, or sharp pelvic pain that require emergency treatment.
Fibroids
Uterine fibroids are non-cancerous growths of the uterus that often appear in women during their reproductive years. Fibroids do not always cause symptoms but when they do, the following may be experienced:
- Pelvic pain or severe menstrual cramps
- Unusually heavy menstrual bleeding that may include clots
- Bleeding between periods
- Increased urination frequency
The presence of these symptoms should always be discussed with your doctor.
A more detailed account of fibroids, its symptoms, diagnosis and management may be found here.
Endometriosis
Endometriosis is a medical condition in which tissue cells that normally line the inside of the uterus (the endometrium) begin to grow on the outside of the uterus instead. This can lead to symptoms of
- Heavy bleeding
- Cramping
- Painful intercourse
- Pain during bowel movements or urination
The presence of these symptoms should always be discussed with your doctor.
A more detailed account of endometriosis, its symptoms, diagnosis and management may be found here.
Pelvic inflammatory disease
Pelvic inflammatory disease (PID) is an infection of a woman’s reproductive organs that usually follows on after infection with a sexually transmitted infection (STI). PID is often caused by STI’s like chlamydia and gonorrhea.
PID is a serious medical condition and must be treated by a doctor as soon as possible. Failure to treat PID quickly can lead to long term complications with infertility.
Symptoms of PID
- Pain in the lower abdomen
- A high temperature
- Symptoms of an STI (ie. unusual discharge from the vagina)
- Pain and/or bleeding during intercourse
- Burning sensation when passing urine
- Bleeding between periods
All of these symptoms, particularly a high temperature, unusual vaginal discharge and abdominal pain warrant a trip to see the doctor immediately.
Women at risk of getting PID
Women are more likely to get PID if:
- They are infected with an STI that goes untreated
- Have more than one sex partner
- Have had PID before
- They engage in unprotected sex
Diagnosis and treatment
Pelvic inflammatory disease can be diagnosed by your doctor after they take a full medical history and carry out physical examination. Treatment of PID is usually a course of antibiotics. However, antibiotics will not be able to cure any damage that may have been done to the reproductive system as a result of the infection itself. That is why it is important to see your doctor immediately if these symptoms occur.
Ovarian cysts
Ovarian cysts are fluid-filled sacs that are found in an ovary or on its surface. Most ovarian cysts are harmless and will disappear on their own. In a few cases, cysts may become extremely large in size (and start to cause symptoms), they may rupture or develop worrying signs that need to be investigated.
Symptoms of a cyst
- Pelvic pain that is dull or sharp
- A sensation of fullness or heaviness in the abdomen
- Bloating
- Difficulty passing urine or frequent need to urinate
- Difficulty emptying the bowels
- Feeling of fullness after only eating a small amount
- Pain during intercourse
- Bleeding in between periods
Types of ovarian cyst and scenarios that may occur
The following are different types of ovarian cysts that may occur or scenarios that may be experienced
Functional cysts
The ovaries normally grow cyst-like structures called follicles each month. These follicles produce estrogen and progesterone and are related to the menstrual cycle. Functional cysts are non-cancerous (benign) and are usually harmless. Functional cysts may be follicular cysts or luteal cysts. They can sometimes cause symptoms of pelvic pain. Most will disappear in a few months without needing any treatment.
Pathological cysts
Pathological cysts are cysts that are abnormal. They are not related to the menstrual cycle, are caused by abnormal cell growth and always require further investigation by a doctor. Pathological cysts include: dermoid cysts, cystadenomas and endometriomas. Pathological cysts share many of the same symptoms as functional (harmless) cysts. That is why it is important to see a doctor if the symptoms mentioned above are experienced. Formal diagnostic testing is the only way to determine whether a cyst is harmless or not.
Ruptured ovarian cyst
Although rare, a ruptured ovarian cyst is a medical emergency. A ruptured cyst can cause sudden, intense abdominal pain and internal bleeding. Any sudden and severe pain of the abdomen or pelvis requires urgent medical attention.
Diagnosis for cysts
Your doctor may be able to detect the presence of a cyst on routine pelvic examination. An ultrasound scan may be required to formally determine the type of cyst that has been found.
Treatment for cysts
Treatment of a cyst will depend on its size, appearance, the presence of symptoms and the type of cyst that has been found.
Because the majority of cysts disappear after a few weeks or months, your doctor may take what is called a watch-and-wait approach to see how the cyst behaves. To do this, they will recommend a repeat ultrasound test in a few weeks or months to check your condition.
A cyst that is not going away on its own or that is causing aggressive symptoms may be treated with birth control pills or a laparoscopy (surgical removal of the cyst).
If more worrying features of the cyst are found then more detailed treatment options will be discussed.
Urinary Tract Infections
Urinary Tract Infections (UTIs) are common infections that affect the bladder, kidneys, and other parts of the urinary system. They are most often caused by bacteria, such as E. coli, entering the urinary tract. Women are particularly prone to UTIs due to their shorter urethra, which allows bacteria easier access to the bladder.
Symptoms of a UTI
- A burning sensation when urinating
- Frequent urination, often with small amounts of urine
- Cloudy, dark, bloody, or strange-smelling urine
- Pelvic pain, especially in the center of the pelvis and the pubic bone
It’s important to seek medical attention if you experience these symptoms, as UTIs can lead to more serious infections if left untreated.
Women at risk of getting UTIs
Certain factors can increase the risk of developing a UTI, including:
- Sexual activity, particularly unprotected sex, which can introduce bacteria into the urinary tract
- Certain types of birth control, like diaphragms or spermicidal agents
- Menopause can change the urinary tract and make it more vulnerable to infection
- A previous UTI, as having one UTI increases the risk of another
Diagnosis of UTI
Diagnosing a UTI will require an appointment with a trained medical professional. Your provider may look to analyze a urine sample for signs of infection, such as bacteria and white blood cells.
Treatment of UTI
Treatment typically includes a course of antibiotics to kill the bacteria causing the infection. It’s crucial to complete the entire course of antibiotics even if symptoms improve before the medication is finished to ensure the infection is fully eradicated.
Preventative Measures for UTIs
Preventive measures include drinking plenty of water, urinating when the need arises, and wiping from front to back after using the toilet to prevent bacteria from entering the urethra.
However, even with preventative measures, some women experience chronic UTIs. If that’s the case, review our resource: There’s Hope for Your Chronic UTI
Early treatment of UTIs can prevent the infection from spreading to the kidneys, leading to more serious health issues. Therefore, recognizing the symptoms early and seeking prompt medical care are essential steps in managing and preventing UTIs.
Advantia Health: Medical Professionals to Help With Your Pelvic Pain
Are you experiencing pelvic pain? Find a provider with Advantia Health, and schedule your appointment today.