What is pelvic pain?

Pelvic pain is pain in the general pelvic area which may be either on-and-off or constant, for months on end.

What causes pelvic pain?

Chronic pelvic pain may be caused by a range of conditions related to the reproductive, urinary, and digestive organs. Causes of pelvic pain may be any of the following:

  • Endometriosis – this condition involves the uterine lining growing outside the uterus causing issues with the menstrual cycle, leading to the formation of cysts and scar tissue.
  • Pelvic congestion syndrome – this condition is caused by enlarged veins around the uterus and ovaries which cause pain.
  • Fibroids – while fibroids rarely cause pain, however when the blood supply to these growths is deprived, the fibroids die. This process may be painful.
  • Ovarian cysts – most ovarian cysts aren’t problematic; however, multiple or large cysts may rupture and cause pain.
  • Chronic pelvic inflammatory disease – when an infection causes scar tissues, this may cause pain.
  • Irritable bowel syndrome – although not gynaecological in nature, this condition may cause pain in the pelvic area.
  • Painful bladder syndrome – this condition may cause pain when the bladder fills.
  • Psychological issues - stress or depression may be the cause of chronic pain.
  • A history of sexual assault
  • Musculoskeletal problems – conditions related to the pelvic floor muscles or hernias may cause pain in the lower abdomen.

What are the symptoms?

Each woman may experience different symptoms, pain may be mild and irritating or so severe it impairs daily activities. The most common include:

  • A dull ache in the pelvic region
  • Sharp cramping in the pelvic area
  • Pressure in the lower abdomen
  • Increased pain during intercourse, bowel movements and sitting or standing for long periods of time
  • Constant or on-and-off pelvic pain for the past six months

What are the treatment options?

Due to the complexity of the cause of pelvic pain, identifying a single cause is often not possible, and thus treatment is aimed to reduce the symptoms of chronic pelvic pain. Diagnostic laparoscopy may be necessary to determine the cause of pain. Because pelvic pain can affect a woman’s quality of life, depending on the cause of the pelvic pain treatment may differ. The following treatment methods may be considered:

  • Pain medications or antidepressants may be used to ease the pain
  • Contraception if the hormones involved in the menstrual cycle are a causing factor
  • Antibiotics if the infection is the cause
  • Physical therapy may aid in relaxation techniques and muscular stretches
  • Numbing injections to block pain
  • Laparoscopic surgery may be an option in necessary cases
  • In severe and suitable cases, a hysterectomy may be considered