Pelvic Pain in Women

Pelvic Pain in WomenPelvic pain is pain that occurs in the lower abdomen below the belly button. It is a common complaint among women and may or may not require medical or surgical intervention.

About Pelvic Pain

Pelvic pain varies in intensity from mild to severe and is linked to a variety of conditions. Pain persisting for a period of six months or longer is categorized as chronic pelvic pain. A gynecologist should always be consulted for pelvic pain that continues or worsens.

Pelvic Pain Causes

There are numerous conditions that can cause pelvic pain ranging from life threatening to mild in nature including, but not limited to:

  • Menstrual Cramps
  • Pelvic Inflammatory Disease
  • Endometriosis
  • Irritable Bowel Syndrome
  • Ectopic Pregnancy
  • Ovarian Cysts
  • Uterine Fibroids
  • Urinary Tract Infection
  • Interstitial Cystitis (chronic bladder inflammation)
  • STDs
  • Scar Tissue from previous surgery or infection
  • Neurologic disorders

Diagnosing Pelvic Pain

Following a complete medical history and physical, your gynecologist will perform a pelvic examination and other appropriate diagnostic tests. Depending on your symptoms, your physician may order a combination of the following: blood and urine tests, x-rays or other imaging tests (CT, MRI, Ultrasound), laparoscopy, cystoscopy and other more specific tests needed to pinpoint the cause of your pelvic pain.

A thorough history and targeted physical examination remain the most important elements of your evaluation.

Treatment of Pelvic Pain

Once the source of pain is identified, an appropriate treatment is initiated. Some evidence-based treatments that reduce or alleviate pelvic pain include the following:

Medications:

Analgesics – particularly non-steroidal anti-inflammatory drugs

Progestin –hormone prescribed for pain caused by endometriosis or pelvic congestion syndrome

Oral Contraceptives – used in the treatment of pain linked to primary dysmenorrhea (painful menstrual periods)

GnRH – gonadotropin-releasing hormone agonists are an appropriate treatment for pelvic pain due to endometriosis or endometriosis-like symptoms and irritable bowel syndrome

Anesthetic Injections – pain medications administered at the site of pain

Antidepressants – specific types have been shown to provide pain relief in specific situations

Medications for specific diagnoses – Interstitial cystitis, for example

Surgical Treatment:

Removal of endometriosis or scar tissue performed through a minimally invasive laparoscopic procedure.

Corrective surgery–removal of fibroids or other surgically correctable problems

Hysterectomy – for treatment of pain associated with the uterus

Sacral nerve stimulation –implanted device that carries impulses to the sacral nerves in the lower back

Non-surgical, non-medical therapy:

Physical therapy – Targeted physical therapy may be beneficial for some types of chronic pelvic pain           

Physical exercise regimens, warm baths, relaxation techniques, yoga and other measures  may also be beneficial