Pelvic pain refers to the discomfort and pain you may feel in the lower abdominal area of your body. The pain may not be contained there, but can in fact radiate into your lower back, buttocks and thighs, depending on the cause or source of the pain. Pelvic pain in women is most often traced to the reproductive system, digestive system, urinary system or musculoskeletal system. Pelvic pain should always be evaluated with a thorough consultation and examination by a physician for an accurate diagnosis and treatment plan as it may be a symptom or sign of a serious illness or condition.
Symptoms that fall under pelvic pain vary a great deal because there are so many possible sources of this symptom and several body systems to check. Pain may be:
- Dull or sharp
- Intermittent or constant
- Mild, moderate or severe
- Localized — that is, in one specific area, as opposed to radiating pain
- Sudden, built over time, acute, sharp or constant — constant pain is referred to as chronic pain, which is pain that has been present for at least 12 weeks or several months
- Present only with certain movements or situations, such as pelvic pain during sex
- Described as pelvic cramps
In the event that the pain is acute and persistent, you should make an appointment to see your doctor right away.
What Causes Pelvic Pain?
Since pelvic pain can stem from one of several systems, there are a variety of causes, usually narrowed down by pain type, including:
- Appendicitis, which is typically felt on your right side
- Inguinal hernia
- Kidney stones
- Urinary tract
- Colon cancer
- Chronic constipation
- Crohn’s disease
- Painful bladder syndrome
- Irritable bowel syndrome
- Pelvic floor muscle spasms
- Ulcerative colitis
- Past physical trauma or abuse, sometimes resulting in pubic bone pain which is common with sports injuries
- Past sexual abuse
Female Pelvic Pain
A woman may experience pelvic pain that is derived from the reproductive system. It can stem from:
- Adenomyosis, which is when cells from the uterine wall begin growing within the uterine muscle itself, continuing to grow, break down and shed every month, causing pain and periods that are heavy and painful
- Endometriosis, which is when cells from the uterine wall, called the endometrium, begin to grow on the outside of the uterine wall. This often is very painful. It can also impact other organs, such as your ovaries, fallopian tubes and the tissues of your pelvic area.
- Menstrual cramps, which can present as sharp pain in vaginal area
- Tubal pregnancy, is a common cause of pelvic pain during pregnancy and happens when a fetus begins developing in your fallopian tubes
- Ovulation pains, which differ from appendicitis pains; this is often felt as lower left abdominal pain in women, as opposed to the pains on the right felt with appendicitis
- Ovarian cysts or cancer
- Pelvic inflammatory disease (PID), a sexually transmitted bacterium that spreads from your vagina into the female reproductive organs; PID is often present without symptoms
- Uterine fibroids
- Vulvodynia, or chronic vaginal pain without a clear root cause
- Vaginitis, an inflammation of your vagina that can be caused by a viral infection, an STD or a yeast infection
- Vaginismus, whereby anything that enters the vagina causes pain, even when trying to use a tampon or during a medical exam
Testing for Pelvic Pain
As always, your doctor performs a physical exam during your visit to see if he can determine the cause of the pain with any tests. At the very least, he should be able to rule out the systems that aren’t the source. There are then some routine tests, like blood tests, urinalysis, a pregnancy test and Pap smear. If those don’t reveal a diagnosis, your doctor moves onto:
- Ultrasound, which allows your OBGYN to see your internal organs via sound waves
- CT scan, used when X-rays come back negative, but your doctor still suspects an abnormality — this scan uses X-rays in combination with computer technology to see your organs in a cross-section as slices
- MRI, which produces two-dimensional images of your organs
- Laparoscopy, classified as a minor surgical procedure, where your doctor creates a small incision in your abdominal wall so that a lens and light may be inserted to see any endometrial growths
- X-rays or a picture of your bones and organs; a typical film for a doctor to order
- Colonoscopy, a routine procedure for anyone over the age of 50, which, through the use of a lighted lens, can see the entirety of the interior of your intestines, going in via your rectum
- Sigmoidoscopy, another procedure where your doctor uses a special scope, inserted in your rectum, to see the inside of your intestines, this time after blowing in air to inflate them, which allows for easier viewing
Diagnosis and Treatment
Once your doctor has run tests and checked each of your systems carefully, he should be able to either give you a clear diagnosis or refer you to a specialist. When the cause is within your reproductive system, your gynecologist may prescribe pain medications, an antibiotic or surgery where necessary. You may be asked to try oral contraceptives if the pain is hormone-related or related to your menstrual cycle. Pelvic pain should always be evaluated with a thorough consultation and examination by a physician for an accurate diagnosis and treatment plan as it may be a symptom or sign of a serious illness or condition and careful follow up should always be performed.
Women often experience pelvic pain, and sometimes there isn’t a cause that can be discerned. In those cases, you may be told to try anti-inflammatory or pain relief medication, relaxation exercises or physical therapy. Your treatment also may involve a multi-pronged approach of dietary changes, exercise, stress relief or even environmental changes. If none of these treatments seems to help, you may come away with the diagnosis of chronic pelvic pain syndrome (CPPS). CPPS is classified as pelvic pain that has been present for six months or more and does not respond to treatment.
Important Reminder: This information is only intended to provide gynecology guidance, not a definitive medical advice. Please consult obgyn doctor about your specific condition. Only a trained, experienced board certified gynecologist or certified gynecology specialist can determine an accurate diagnosis and proper treatment.
Do you have questions about Pelvic Pain? Would like to schedule an appointment with the NYC top Gynecologist, Dr. Pedram Bral, please contact our office.
Dr. Pedram Bral, Gynecologist (Gynecologist NYC, Midtown)
New York, NY10010
(Between Madison Ave & Park Ave)
☎ (212) 533-4575