Pelvic Pain: Causes, Symptoms and Treatment
Pelvic pain refers to discomfort in the lower abdominal area and can have many causes. It affects both women and men and may be acute or chronic.
Things worth knowing about "Pelvic Pain"
Pelvic pain refers to discomfort in the lower abdominal area and can have many causes. It affects both women and men and may be acute or chronic.
What Is Pelvic Pain?
Pelvic pain describes pain felt in the lower abdomen, below the navel. It can be dull, pulling, cramping, or sharp in nature and may be temporary or persistent. Pelvic pain is a common symptom with a wide range of potential causes, affecting both women and men of all ages.
Causes
The causes of pelvic pain vary depending on gender, age, and accompanying symptoms. A number of different conditions may be responsible.
Common Causes in Women
- Menstrual cramps (dysmenorrhea): Cramping pain during the menstrual period
- Ovarian cysts: Fluid-filled sacs on the ovaries
- Endometriosis: Uterine lining tissue growing outside the uterus
- Uterine fibroids: Benign muscle growths in the uterus
- Pelvic inflammatory disease (PID): Infection of the uterus or fallopian tubes
- Ectopic pregnancy: A life-threatening medical emergency
Common Causes in Men
- Prostate problems: Inflammation or enlargement of the prostate gland
- Testicular torsion: Twisting of the testicle – a medical emergency
- Inguinal hernia: Protrusion of tissue through a weak spot in the abdominal wall
Causes Affecting Both Women and Men
- Urinary tract infections (UTI): Bacterial infections of the bladder or urinary tract
- Kidney stones: Mineral deposits in the kidneys or urinary tract
- Bowel conditions: e.g., irritable bowel syndrome, Crohn disease, ulcerative colitis
- Appendicitis: Inflammation of the appendix – a medical emergency
- Constipation: Difficulty or infrequent bowel movements
- Hernias: Various forms of abdominal wall weakness
Symptoms and Associated Complaints
Pelvic pain can occur alone or alongside other symptoms. Common accompanying complaints include:
- Nausea and vomiting
- Bloating or diarrhea
- Fever or chills
- Pain during urination
- Irregular menstrual cycle
- Unusual discharge or bleeding between periods
- Pain during sexual intercourse
When to Seek Medical Attention
Immediate medical evaluation is strongly recommended in the following situations:
- Sudden onset of severe pain
- Pain accompanied by fever above 38.5 °C (101.3 °F)
- Bleeding outside of a normal period or during pregnancy
- Suspected pregnancy with pelvic pain
- Pain following an accident or fall
- Persistent pain lasting several days without a clear cause
Diagnosis
Several diagnostic methods are available to evaluate pelvic pain:
- Medical history and physical examination: The doctor asks about the nature, duration, and accompanying symptoms of the pain.
- Ultrasound (sonography): Imaging technique to visualize organs in the pelvic region
- Blood and urine tests: To detect inflammation, infection, or hormonal imbalances
- Pregnancy test: For women of childbearing age
- Gynecological examination: Including smear test and speculum examination
- CT or MRI scan: For detailed imaging in unclear cases
- Laparoscopy: Minimally invasive surgical examination, e.g., when endometriosis is suspected
Treatment
Treatment depends on the underlying cause:
- Pain relievers: e.g., ibuprofen or paracetamol for mild to moderate pain
- Antibiotics: For bacterial infections such as UTIs or PID
- Hormone therapy: For endometriosis, fibroids, or menstrual disorders
- Surgical procedures: For cysts, fibroids, appendicitis, or ectopic pregnancy
- Physiotherapy and pelvic floor training: For chronic pelvic pain
- Dietary changes: For irritable bowel syndrome or chronic constipation
References
- Ahangari A: Prevalence of chronic pelvic pain among women: an updated review. Pain Physician. 2014;17(2):E141-E147.
- Burnett M, Lemyre M: No. 345-Primary Dysmenorrhea Consensus Guideline. Journal of Obstetrics and Gynaecology Canada. 2017;39(7):585-595.
- World Health Organization (WHO): Reproductive health – Endometriosis. Available at: https://www.who.int/news-room/fact-sheets/detail/endometriosis (accessed 2024).
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