Pelvic Pain in Women

pelvic pain in women

What is the pelvis?

The pelvis is the lowest part of your abdomen. Organs in the pelvis include the bowel, bladder, womb and ovaries. Pelvic pain usually means pain that originates from one of these organs. In some cases the pain comes from the pelvic bones that lie next to these organs, or from nearby muscles, nerves, blood vessels or joints. So, there are many causes of pelvic pain.Pelvic pain is more common in women than in men.

What are the causes of pelvic pain?

Problems associated with pregnancy

  1. Miscarriage: miscarriage is the loss of a pregnancy at any time up to the 24th week.
  2. Ectopic pregnancy: an ectopic pregnancy is a pregnancy that tries to develop outside the womb.
  3. Rupture of corpus luteum cyst: a corpus luteum makes hormones that help keep you pregnant, until other organs such as the placenta take over. It is part of the egg-making process in your ovary. They are usually found when you have your ultrasound scan.
  4. Premature labour: normally labour starts after 37 completed weeks of pregnancy.
  5. Placental abruption: rarely (about 6 times in every 1,000 deliveries), the placenta detaches from the wall of the womb. Before 24 weeks of pregnancy this is a miscarriage, but after 24 weeks it is called an abruption.

Gynaecological problems

  1. Ovulation: ovulation means producing an egg from your ovary.
  2. Dysmenorrhoea: most women have some pain during periods.
  3. Pelvic inflammatory disease (PID): PID is an infection of the womb.
  4. Rupture or torsion of ovarian cyst: an ovarian cyst is a fluid-filled sac which develops in an ovary. Most ovarian cysts are non-cancerous and cause no symptoms. Some cause problems such as pain and irregular bleeding. Pain may happen when they rupture (burst) or twist (called torsion).
  5. Degenerative changes in a fibroid: fibroids are non-cancerous growths in the womb. They are common and usually cause no symptoms. However, they can sometimes cause heavy periods, abdominal swelling and urinary problems. Rarely, the fibroid outgrows its blood supply. This can make it degenerate (shrink) which can be very painful.
  6. Endometriosis: It causes pain around the time of your period. It may also cause pain when you have sex.
  7. Chronic pelvic pain: this is the term used when a woman has had pain for 3-6 months. Sometimes a cause is found, such as those above, and sometimes there is no obvious cause.
Problems with bowels or bladder
  1. Appendicitis
  2. Irritable bowel syndrome (IBS)
  3. Cystitis
  4. Adhesions
  5. Strangulated hernia: A hernia strangulates when too much bowel has come through the gap in the muscle or ligament and then becomes squeezed. This can cut off the blood supply to the portion of intestine in the hernia.

Problems with the lower back, bones in the pelvis and nearby joints such as the hip joints can cause pain.

What should I do if I have pelvic pain?

If you are not sure of the cause of the pain or if the pain is severe, you should see a doctor. In particular, some causes are emergencies - for example, an ectopic pregnancy.

What investigations may be advised?

A urine infection is a very common cause of pelvic pain and your doctor may ask for a urine sample. A pregnancy test may be advised if you are unsure. They may arrange an urgent ultrasound (if miscarriage or ectopic pregnancy is suspected) at your local hospital. Laparoscopy is commonly used by gynaecologists. Doctors who specialize in the bowel may use flexible telescopes to look inside your bowel. The food pipe and stomach can be seen by gastroscopy. The lower bowel (rectum and colon) are looked at by colonoscopy

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