Pelvic Pain

Pelvic pain, usually perceived as stomach ache, is a commonly experienced discomfort in the lower abdomen and pelvic areas. It can arise suddenly or develop slowly over time, sometimes, causing severe problems. Understanding the causes, symptoms, and treatments for pelvic pain can help identify when medical care is needed. 

Let’s take a look at everything you need to know about Pelvic Pain.

What Is Pelvic Pain?

Pelvic pain refers to soreness, aching, or tenderness felt in the region below the belly button and between the hip bones, on either side. The pain can remain in one spot or radiate to other areas. It can also come and go constantly. Acute pelvic pain starts abruptly and severely, while chronic pelvic pain persists for over 6 months. Pelvic pain stems from issues in the reproductive, urinary, digestive, or nervous systems.

Symptoms of Pelvic Pain

Pelvic pain has several associated symptoms, such as:

• Vaginal bleeding or discharge
• Menstrual cramps
• Painful urination
• Constipation or diarrhoea
• Abdominal bloating/gas
• Rectal bleeding
• Pain during sexual intercourse
• Fever or chills
• Hip pain
• Groyne pain

Symptoms help determine whether the pelvic pain is acute or chronic. Sudden, severe pelvic pain with other symptoms like bleeding or fever often indicates an acute condition needing prompt medical care.

What Causes Pelvic Pain?

Both acute and chronic pelvic pain have many possible causes, such as:

• Ectopic Pregnancy - embryo implants outside the womb
• Pelvic Inflammatory Disease - reproductive organ infection
• Ovarian Cysts - Ovary sacs that are filled with fluid
• Endometriosis - uterine tissue grows outside the womb
• Uterine Fibroids - benign growths in the womb
• Scar tissue between pelvic organs
• Cancer in reproductive organs or colon
• Digestive issues like constipation or diarrhoea
• Urinary problems such as infections
• Musculoskeletal problems in the back or hips

Possible causes of pelvic pain in women and female at birth (AFAB) include:

• Pregnancy: When a fertilized egg implants in the uterus and starts to grow, leading to the development of a baby.
• Ectopic Pregnancy: This happens when a fertilized egg implants outside the uterus, often in the fallopian tube. It can be dangerous and requires medical treatment.
• Miscarriage: The loss of a pregnancy before the 20th week, usually because of problems with the baby or the mother’s health.
• Pelvic Inflammatory Disease (PID): An infection of the reproductive organs in women, often caused by sexually transmitted infections. It can lead to pain and problems with fertility.
• Ovulation: The process where an ovary releases an egg, which can then be fertilized by sperm. It usually happens once a month in the middle of the menstrual cycle.
• Menstrual Cramps: Pain in the lower abdomen that many women experience before or during their period, caused by the uterus contracting.
• Ovarian Cysts: Fluid-filled sacs that can form on the ovaries. They are usually harmless but can sometimes cause pain or other issues.
• Uterine Fibroids: Non-cancerous growths in the uterus that can cause heavy periods, pain, or other symptoms.
• Endometriosis: A condition where tissue similar to the lining of the uterus grows outside it, causing pain and sometimes fertility problems.
• Cervical Cancer: Cancer that starts in the cervix (the lower part of the uterus) and can be caused by certain types of human papillomavirus (HPV).
• Uterine Cancer: Cancer that starts in the lining of the uterus, often causing abnormal bleeding or pain.
• Ovarian Cancer: Cancer that begins in the ovaries, which can cause symptoms like bloating, abdominal pain, or changes in bowel habits.

Identifying the cause of pelvic pain through proper diagnosis guides appropriate treatment.

Diagnosis

To determine the cause of pelvic pain, doctors will begin with questions about your symptoms:

• When did the pain start and where exactly is it located? This helps identify the source.
• How long does it last? Acute pain starts suddenly while chronic pain persists.
• Is it related to your period, peeing, or sex? This points to potential reproductive or urinary causes.
• How does it really feel like - dull, sharp, or any cramping? This will help your healthcare provider to understand the level of pain.
• Under what circumstances did it begin? Onset during exercise or sex suggests muscular or organ involvement.
• Did it begin slowly or suddenly? Gradual onset hints at chronic conditions like endometriosis while sudden onset suggests infection or cysts.
• Also describe how it affects your daily activities like eating, sleeping and moving.

Doctors also take a complete medical history with physical and pelvic exams. They may order:

• Bloodwork to check for infection or inflammation.
• Pregnancy test if it could be a factor.
• Urinalysis to look for UTI.
• Cervical cell culture to check for STD.

Imaging tests can identify issues:

• Ultrasound uses sound waves to visualise pelvic organs.
• A CT scan - uses X-rays and computers to give detailed images
• MRI provides a detailed cross-sectional view without radiation.
• Laparoscopy inserts a tube with a camera to directly see organs.

Other procedures check specific areas:

• X-ray views bones and organs.
• A colonoscopy - it examines the colon with a tube inserted through the rectum
• Sigmoidoscopy inserts a flexible tube into the lower colon through the rectum.

Providing complete information about symptoms aids in the diagnosis of pelvic pain causes and proper treatment.

Treatment

Pelvic pain treatment depends on:

• Your health history and condition extent - this provides context.
• The diagnosed cause - guides appropriate treatment.
• Your tolerance for medications or therapies - considers side effects.
• Expectations for improvement or control - set realistic goals.
• Your preferences - incorporate patient values.

Treatments may involve:

• Antibiotics for infections.
• Anti-inflammatories and pain medicine to alleviate discomfort.
• Hormonal birth control to address reproductive issues.
• Surgery to remove cysts, fibroids, or scar tissue.
• Physical therapy to improve musculoskeletal function.
• Relaxation techniques to help chronic pain.
• Nutritional or environmental modifications as needed.

For undiagnosed chronic pain, providers may recommend:

• Counselling to develop coping strategies.
• Multidisciplinary treatment combines different approaches for complete personal care.
• The aim is to identify the factors causing pain and provide appropriate targeted treatment. 

Ongoing collaboration with your healthcare team is key to successfully resolving or managing pelvic pain.

Prevention

While you might not be able to prevent pelvic pain entirely, you can lower your risk by following these tips:

• Avoid Overdoing It: Try to limit activities that involve standing or walking for long periods.
• Increase Fiber Intake: Eating more fiber can be beneficial, especially if your pelvic pain is related to diverticulitis.
• Stay Active: Regular exercise helps maintain healthy joints and muscles.
• Stretch Before Exercise: Warming up and stretching before physical activity can help prevent pelvic pain.
• See Your Doctor Regularly: Routine check-ups can help catch potential issues early before they become serious.

Home Remedies For Pelvic Pain

While home remedies do not treat underlying causes of pelvic pain, they can temporarily ease chronic discomfort. Options to try at home include:

• Taking over-the-counter pain medication like ibuprofen, naproxen sodium, or acetaminophen to reduce inflammation and alleviate pain. Follow dosage instructions carefully.
• Make time for light exercise such as walking, even if you don't feel like moving. Exercise improves blood circulation which helps minimise pain. Start slow and gradually increase the intensity and number of exercises.
• Apply heat to the painful area with methods like a warm compress, heating pad, or hot water bottle. The warmth can relieve muscle tension and soothe nerves.
• Stopping smoking and avoiding tobacco, if a smoker, as nicotine restricts blood vessels which can worsen pain. Quitting improves blood flow.
• Taking supplements if the deficiency in vitamins or minerals is causing symptoms. Discuss supplement use with your doctor first for appropriate selection and dosage.
• Practice relaxation methods that include mindfulness, meditation, or even yoga. These can reduce stress and anxiety, easing the perception of chronic pain.
• Keeping a pain journal to identify triggers and track the effectiveness of remedies tried. Share the journal with your doctor.

Though home remedies only provide temporary relief from pelvic pain, they can be helpful when combined with medical treatment. Remember to consult your healthcare provider before using any new approach for pelvic pain management.

When To See a Doctor?

Contact a healthcare provider urgently if pelvic pain:

• Starts suddenly or severely
• Prevents standing upright
• Includes bleeding or fever
• Occurs alongside pregnancy

Also, see a doctor if pelvic pain persists over 2 weeks and interferes with daily activities. Do not try to self-diagnose sudden or severe pelvic pain.

Conclusion

Pelvic pain has many potential causes, from cysts to infections. Identifying the source of pain through medical evaluation is essential for proper medical treatment. While home remedies temporarily ease discomfort, see a doctor right away if pelvic pain is severe or accompanied by concerning symptoms. Ongoing care from a healthcare provider can successfully resolve or manage most causes of pelvic pain.

FAQs

1. How do you know if pelvic pain is serious?

Seek emergency care for sudden, severe pelvic pain or pain causing inability to stand upright. Also, go to emergency care for pelvic pain with symptoms like bleeding or fever, or if pregnant/recently pregnant. These indicate a potentially serious condition needing immediate treatment.

2. When should I be concerned about pelvic pain?

Contact your doctor if pelvic pain lasts over 2 weeks, occurs alongside worrying symptoms, or interferes with daily life. While not always serious, persistent pelvic pain should be evaluated to identify the cause and proper treatment. Do not try to self-diagnose unexplained chronic pelvic discomfort.

3. Where is pelvic pain located?

Pelvic pain is typically located in the lower part of your abdomen, between your belly button and your hips.

4. Is walking bad for pelvic pain?

Walking can be beneficial or harmful depending on the cause of the pelvic pain. Light walking is generally okay, but if it worsens the pain, it's best to rest and consult a doctor.

5. Can anxiety cause pelvic pain?

Yes, anxiety can cause pelvic pain. Stress and tension can lead to muscle tightness in the pelvic area, resulting in discomfort.

6. How to tell the difference between pelvic pain and abdominal pain?

Pelvic pain is usually felt lower in the abdomen, closer to the hips and groin, while abdominal pain is felt higher up, around the stomach area.

7. How do you know if pelvic pain is serious?

Pelvic pain is serious if it is severe, sudden, or accompanied by symptoms like fever, vomiting, or unusual discharge. In such cases, seek medical attention immediately.

8. Is it normal to have pelvic pain every day?

It is not normal to have pelvic pain every day. Persistent pelvic pain should be consulted by a healthcare provider to determine the cause.

9. Why do I suddenly have pelvic pain?

Sudden pelvic pain can be caused by various factors, such as infections, injuries, or conditions like ovarian cysts. If the pain is severe or doesn't go away, see a doctor.

CARE Medical Team

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