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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.

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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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