Pelvic 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
- Irritable Bowel Syndrome
- Ectopic Pregnancy
- Ovarian Cysts
- Uterine Fibroids
- Urinary Tract Infection
- Interstitial Cystitis (chronic bladder inflammation)
- 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:
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
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