Pelvic pain is any pain or discomfort in your lower abdomen or pelvis, the area between the hip bones. In women, various conditions related to the reproductive, urinary, digestive or musculoskeletal systems can cause pelvic pain.
It is vital to address pelvic pain as it can significantly impact your quality of life and indicate an underlying health issue requiring medical attention, such as a sexually transmitted infection (STI), ovarian cancer or an ectopic pregnancy.
In this blog post, we will examine the gynaecological conditions that cause pelvic pain in women, as well as the symptoms and available treatments. Discover all of this with The McIndoe Centre.
Gynaecological conditions
Pelvic pain is a common symptom of several gynaecological conditions.
Endometriosis is a condition where the tissue lining of the uterus (endometrium) grows outside it, causing inflammation and pain. Endometriosis can cause pelvic pain, painful periods, pain during sex and infertility. Treatment for endometriosis may include pain medications, hormone therapy or surgery.
Fibroids are non-cancerous growths that develop in the uterus. They can cause heavy menstrual bleeding, pelvic pain and pressure on the bladder or bowel. Treatment for fibroids may include medication, non-invasive procedures or surgery — depending on the fibroids’ size and locations.
Pelvic inflammatory disease (PID) is an infection of the reproductive organs that can cause inflammation and pain in the pelvis. STIs such as chlamydia or gonorrhoea are the typical cause. PID symptoms may include pelvic pain, fever and abnormal vaginal discharge. Treatment for PID involves antibiotics and hospitalisation in severe cases.
Adenomyosis is when the endometrial tissue grows into the muscle layer of the uterus, causing pain and heavy menstrual bleeding. Adenomyosis can also cause pelvic pain, painful periods and bloating. Treatment for adenomyosis may include pain medication, hormone therapy or surgery.
Vulvodynia is a chronic pain condition that affects the vulva. Vulvodynia can cause pain, burning or itching in the vulva area, making sex or other activities uncomfortable or painful. Treatment for vulvodynia may include medication and physical therapy.
Urinary tract infections
Urinary tract infections (UTIs) are a common bacterial infection that affects the urinary system, which includes the kidneys, bladder, ureters and urethra. UTIs can occur in men and women, but they are more common in women.
Symptoms of UTIs
The symptoms of UTIs may vary depending on the part of the urinary system that is affected. Some of the most common symptoms of UTIs include:
- Pain or burning sensation during urination
- Frequent urge to urinate
- Passing small amounts of urine frequently
- Cloudy or foul-smelling urine
- Blood in the urine
- Pelvic pain or discomfort
- Fever or chills
Diagnosis of UTIs
Your doctor will likely ask about your symptoms and medical history to diagnose a UTI. They may also perform a physical exam and order tests, such as a urine test, to confirm the presence of bacteria in your urine.
Treatment of UTIs
Doctors treat UTIs with antibiotics. The antibiotic type and the treatment length will depend on your infection’s severity and other factors such as your age and medical history.
Prevention of UTIs
There are several ways to prevent UTIs from starting, including:
- Wiping front to back after using the toilet
- Urinating frequently and completely
- Drinking plenty of water to flush out bacteria
- Avoiding the use of irritating feminine products
- Emptying your bladder after sex
Ovarian cysts
Ovarian cysts are fluid-filled sacs that develop on the ovaries. Most ovarian cysts are harmless and go away by themselves, but some can cause pain and other symptoms.
Symptoms
Many ovarian cysts don’t cause any symptoms, but some symptoms can occur, such as:
- Pelvic pain or discomfort
- A full feeling or pressure in the lower abdomen
- Abdominal bloating or swelling
- Changes in your menstrual cycle, such as irregular periods or heavy bleeding
- Pain during sex
- Difficulty urinating or having a bowel movement
Diagnosis
Ovarian cysts are often found during a pelvic exam, ultrasound or other imaging tests, such as a CT scan or MRI. Your healthcare provider may also do blood tests to check for tumour markers, which can help diagnose the cyst type.
Treatment
Treatment for ovarian cysts depends on the type and size of the cyst, and your age and symptoms. Most small cysts will go away on their own without treatment. However, doctors may need to treat larger cysts or those causing problematic symptoms.
If tests find the cyst is non-cancerous, doctors may monitor it to see if it goes away on its own or grows larger. They may prescribe hormonal contraceptives to help shrink the cyst and prevent new ones from forming.
In some cases, surgery may be necessary to remove the cyst. The surgeon may be able to carry out the procedure through laparoscopy, which involves making small incisions in the abdomen and using a tiny camera to guide them, or laparotomy, which means making a larger incision.
If the cyst is cancerous, treatment may include surgery, chemotherapy or radiation therapy.
Symptoms of pelvic pain
Not all pelvic pain symptoms are the same, and women can feel them at different times.
Pain during sex is a common symptom of pelvic pain. You may feel the pain in your pelvic, lower abdomen or vaginal areas, and it may range from mild discomfort to severe pain. Pain may occur during penetration or after sex. Many factors, such as infections, endometriosis or vaginal dryness can cause it.
Pelvic pain during menstruation is another common symptom of pelvic pain. It can range from mild discomfort to severe cramping, which may cause nausea and vomiting. You can feel the pain in your lower abdomen or back and it can last for several days. Hormonal imbalances, endometriosis, fibroids or ovarian cysts can cause this pelvic pain type.
Pelvic pain during bowel movements is a symptom of pelvic pain that several factors, such as inflammatory bowel disease, irritable bowel syndrome or pelvic floor dysfunction, can cause. The pain can range from mild discomfort to severe cramping and other symptoms such as constipation or diarrhoea can accompany it.
Diagnosis of pelvic pain
Diagnosing the cause of pelvic pain can be challenging as various factors can cause it. Therefore, the diagnostic process typically involves a combination of medical history, physical examination and diagnostic tests.
Medical history
The first step in diagnosing pelvic pain is looking at your medical history. The doctor will ask about the pain’s location, duration and intensity, as well as any other symptoms, such as nausea or fever. They will also ask about your menstrual cycle, sexual history and medical history, including surgeries or pregnancies.
Physical examination
During the physical examination, the doctor will check for any abnormalities in your abdomen, pelvis or genital areas. They may also perform a pelvic exam to check for signs of infections, endometriosis or other gynaecological conditions. In some cases, they may do a rectal or vaginal exam to evaluate the muscles and tissues surrounding your pelvic region.
Diagnostic tests
Diagnostic tests can help identify the underlying cause of pelvic pain. These tests may include:
- Ultrasound – A non-invasive imaging test that uses high-frequency sound waves to produce images of the pelvic area to help identify any cysts, tumours or other abnormalities.
- Blood tests – Used to check for signs of infection, inflammation or other underlying conditions.
- Urine tests – To help identify urinary tract infections or other abnormalities in your urinary system.
- CT or MRI scans – Imaging tests can provide detailed images of the pelvic region. They help identify any tumours, cysts or other abnormalities that may be causing your pain.
- Laparoscopy – A minimally invasive surgical procedure in which a tiny camera is inserted through a small incision in the abdomen to view your pelvic area and identify abnormalities.
Treatment of pelvic pain
The treatment for pelvic pain will depend on the underlying cause, but the main treatments are medication, surgery and lifestyle changes.
Medication
There are several different types of pain medications you might be prescribed for pelvic pain. One type of pain relief medication are nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, which can help relieve pelvic pain.
Your doctor may prescribe hormonal therapy, including contraceptive pills or hormone replacement therapy, if your pelvic pain is related to menstrual cycle changes or hormonal imbalances. They may also prescribe antibiotics if an infection such as PID or a UTI has caused your pelvic pain.
Surgery
Doctors may recommend surgery if a gynaecological condition such as endometriosis or ovarian cysts has caused your pelvic pain.
The type of surgery will depend on the specific condition and severity of your symptoms. Sometimes, surgeons use a laparoscopic procedure to remove or drain the cyst. A hysterectomy (removal of the uterus) or oophorectomy (removal of one or both ovaries) may be necessary in severe cases.
Lifestyle changes
Making lifestyle changes may help alleviate pelvic pain. These changes can include:
- Practising relaxation techniques such as deep breathing, yoga or meditation to reduce stress
- Exercising regularly to improve overall health and relieve tension in your pelvic area
- Maintaining a healthy diet and staying hydrated
- Avoiding or limiting caffeine and alcohol intake, which can irritate your bladder and pelvic area
- Using home remedies such as a heating pad or warm bath
Prevention of pelvic pain
While some causes of pelvic pain may be unavoidable, you can take several steps to prevent or minimise your risk of experiencing pelvic pain.
Maintaining good hygiene
Practising good hygiene is essential in preventing infections that can lead to pelvic pain. This includes regularly washing your genitals with mild soap and water, wearing clean and breathable underwear and changing out of wet clothes, such as swimsuits or sweaty workout clothes, as soon as possible.
It is also essential to wipe from front to back after using the bathroom to prevent bacteria from entering the urethra, as this can cause infections.
Using proper protection during sexual activity
Using protection during sexual activity can help prevent STIs and other infections that can lead to pelvic pain. For example, using a condom can help reduce the risk of STIs, and lubrication can help prevent friction during sex that leads to irritation and pain.
Regular gynaecological check-ups
Regular gynaecological check-ups are important for preventing and detecting conditions that can cause pelvic pain.
It is vital to seek medical attention if you experience pelvic pain, as early diagnosis and treatment can improve outcomes and quality of life.
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