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Pelvic Pain

Pelvic pain is pain that occurs in the lower abdomen and pelvis.

The pelvic region is the area between the umbilicus (belly button) and the groin in the front and between the buttocks at the back.

  • This may involve the any or all of the following
    Reproductive system (uterus, tubes and ovaries)
  • Bladder
  • Digestive system (intestines, stomach)
  • Pelvic Floor

What is Your Pelvic Floor?

Pelvic floor is the group of muscles lining the pelvis. Any diseases or disorders that affect these pelvic floor muscles can lead to pelvic floor deformities.

Local organs can also be affected including the bladder, urethra, vagina, anus, and rectum.

Types of Pelvic Pain

The types of Pelvic pain can vary. They can categorised as:

  • dull or sharp;
  • persistent or intermittent;
  • mild to severe, and
  • can extend to your lower back or thighs.

Symptoms of Pelvic Pain

The common symptoms with pelvic pain are:

  • Pain in the hip and groin area
  • Pain and cramps during menstruation
  • Pain during urination, bowel movements, and intercourse
  • Fever or chills
  • Constipation or diarrhoea

Acute Pelvic Pain

What is Acute Pelvic Pain

Acute Pelvic Pain is usually characterised as pain that

  • Occurs suddenly
  • Stays for a short periods of time.

Causes of Acute Pelvic Pain

Usually, pelvic pain is considered a symptom of infection or a problem in the pelvic area.

It is observed most commonly in women but can also occur in men.

The common causes of acute pelvic pain are:

  • Pelvic inflammatory disease (infection of the reproductive organs),
  • Urinary tract infection
  • Appendicitis (inflammation of appendix)
  • Ectopic pregnancy (pregnancy that occurs outside the uterus)
  • Twisted or ruptured ovarian cyst
  • Ruptured fallopian tube
  • Miscarriage or threatened miscarriage
  • Congestion or abscess (collection of pus) in the pelvic region

Chronic Pelvic Pain

Whats is Chronic Pelvic Pain

Chronic Pelvic Pain is usually characterised as pain that:

  • lasts for more than six months, and
  • does not show any improvement with treatment

Examples of Chronic Pelvic Pain include

  • pain during periods,
  • ovulation,
  • intercourse, and
  • pain when passing urine or bowel movements
  • lower back pain.

Causes of Chronic Pelvic Pain

Chronic Pelvic Pain is constant pain which is felt in the lower abdominal region and is longer in duration - usually longer than six months.

Chronic pelvic pain can be caused by different conditions that may or may not be related to reproductive organs such as pain due to urinary tract conditions (interstitial cystitis).

The cause for the pain may be unknown in some cases, but common causes of chronic pelvic pain

  • Endometriosis, the abnormal growth of uterus lining where the lining of the uterus (endometrium) grows in areas of the pelvis outside the uterus
  • Interstitial cystitis (inflammation of urinary bladder)
  • Irritable bowel syndrome
  • Pelvic floor disorders (spasm or tension in the pelvic floor muscles)
  • Uterine fibroids (non-cancerous uterine growths)
  • Chronic pelvic inflammatory disease
  • Psychological factors such as stress, depression or a history of physical abuse

How is Chronic Pelvic Pain Diagnosed?

To find the cause of chronic pelvic pain some or all of the following diagnostic methods can be used:

  • a medical history
  • a pelvic examination
  • blood tests
  • urine culture
  • Ultrasound
  • X-Ray
  • CT (Computerised Axial Tomography)
  • MRI (magnetic resonance imaging)
  • laparoscopy
  • cystoscopy
  • colonoscopy
  • sigmoidoscopy

Treatments for Pelvic Pain

Treatment for pelvic pain depends on:

  • the cause of pain,
  • intensity of the pain
  • frequency of the pain.

Conservative Treatments for Pelvic Pain

Conservative management of pelvic pain can include:

  • Rest
  • Regular physical therapy including pelvic floor physiotherapy
  • Exercise
  • Nutrition
  • Medication can be used to relieve pain (pain killers) - non steroidal anti-inflammatory drugs may relieve pelvic pain.
  • Vitamin B1 and magnesium supplements may help reduce pain.
  • Muscle spasm/ contraction (muscle relaxants)
  • Dr Gailani may also instruct you to take hormonal medications for pain relief during ovulation and menstruation.
  • If infection has been diagnosed as a cause antibiotics could be prescribed

Surgery to destroy nerves and block pain signals may be considered when all other treatment methods are unsuccessful.

Surgical Treatments for Pelvic Pain

Surgery is considered for patients with chronic pelvic pain when the diagnosis is

  • endometriosis
  • pelvic floor disorders
  • other chronic pelvic problems.

Surgical Procedures to Treat Pelvic Pain

Common surgical options for treating pelvic pain  can include:

  • Laparoscopic surgery (removal of endometriosis or pelvic adhesions)
  • Hysterectomy (removal of uterus)