Pelvic Pain – Causes, Symptoms, Diagnosis and Treatment

Pelvic pain is often associated with internal female reproductive organs, but pelvic pain can also be experienced by men for various reasons.

Pelvic pain can be a symptom of an infection or may arise from pain in the pelvic bones or in non-reproductive organs, such as the bladder or large intestine. In women, however, pelvic pain can very well be an indication that there may be a problem with one of the reproductive organs in the pelvic region, such as the uterus, ovaries, cervix, or vagina.

Causes of Pelvic Pain

What causes pelvic pain? The following are possible causes of pelvic pain in men and women:

Possible causes of pelvic pain in women can only include:

  • Miscarriage
  • Pelvic inflammatory disease
  • Ovulation
  • Menstrual Cramps
  • Ovarian cysts or other ovarian disorders
  • Fibroids
  • Endometriosis
  • Cervical cancer

Risk Factors for Pelvic Pain

Having one of the following disorders or family history can increase a person’s likelihood of experiencing pelvic pain:

  • Endometriosis
  • Fibroids
  • Pelvic inflammatory disease (PID): Infection of female reproductive organs, such as the uterus, fallopian tubes or ovaries. Most often occurs due to complications of sexually transmitted diseases that harm the vagina, spread internally to the uterus and other locations. This is one of the main preventable complications that can cause infertility.

The following are personal risk factors found by researchers that can increase a person’s chances of feeling pelvic pain:

  • History of physical or sexual violence
  • A history of radiation or surgical treatment to the abdomen and pelvis
  • History of anxiety, depression or other psychosomatic symptoms
  • Miscarriage History
  • Infertility
  • Long duration of menstrual flow

Symptoms of Pelvic Pain

What are the symptoms of pelvic pain? The following signs or symptoms in women and men:

  • Worsening of menstrual cramps
  • Menstrual pain
  • Vaginal bleeding
  • Urinating pain or difficulty
  • Constipation or diarrhea
  • Bloating or gas
  • Bloody bowel movements
  • Pain during intercourse
  • Fever or cold
  • Pain in the hip area
  • Pain in the groin area

Diagnosis of Pelvic Pain

How to determine the cause of pelvic pain? To determine what causes pelvic pain, your doctor will first ask a few questions about your symptoms and past medical problems. The doctor will also do a physical exam and may offer a test to determine what is causing your pain. Other tests that can be given include:

  • Blood and urine tests
  • Pregnancy tests in women of reproductive age
  • Vaginal or penile culture to check sexually transmitted diseases such as gonorrhea and chlamydia
  • X-ray images of the abdomen and pelvis
  • Bone density screening – special type of X-ray to determine bone strength
  • Laparoscopic diagnostics – procedures that allow direct viewing of structures in the pelvis and abdomen
  • Stool test – checks stool samples for microscopic blood
  • Lower endoscopy – insertion of a light tube to examine the inside of the rectum and part or all of the large intestine
  • Ultrasound – a test that uses sound waves to give pictures of internal organs
  • CT scan of the abdomen and pelvis – a scan that uses X-rays and a computer to produce a cross-section of the body.

Treating Pelvic Pain

Treatment of pelvic pain varies depending on the cause, how intense the pain is, and how often the pain occurs. Occasionally, pelvic pain is treated with drugs, including antibiotics if necessary. If pain results from problems with one of the pelvic organs, treatment may involve surgery or other procedures. Doctors can provide more information about various treatments for pelvic pain.

Non-surgical treatment
Medications: There are a number of medications that can be prescribed to relieve pelvic pain:

  • Painkillers: These are often prescribed to help reduce pelvic pain, but it is important to note that they will not treat the cause of a person’s pelvic pain, especially in cases of chronic pelvic pain. Painkillers range from analgesics such as nonsteroidal anti-inflammatory drugs (aspirin or ibuprofen) to prescribed narcotics (Vicodin).
  • Birth control: When a patient’s pelvic pain comes during a known time in their menstrual cycle (when different hormone levels rise and fall), birth control or hormonal drugs can be used to try to control this process. This has been proven to reduce female pelvic pain in some cases.
  • Antibiotics: These prescribed drugs are only given in cases of pelvic pain caused by infection to treat PID.
  • Antidepressants: Research has shown that antidepressants can reduce pelvic pain, even for patients who are not depressed. However, this form of the drug is useful for depression that often occurs in cases of chronic pelvic pain.

Surgical treatment
When a patient wants treatment for pelvic pain caused by endometriosis, adenomyosis, fibroids, and others (as opposed to infection), surgery is often the most recommended method. Surgery can vary depending on the patient’s diagnosis:

  • Laparoscopic excision surgery: If done properly, this surgical technique is the most extensive in removing all scar tissue in cases of pelvic pain caused by endometriosis and focal adenomyosis.
  • Myomectomy: This is the removal of fibroids (abnormal growth of cells in the uterus), which in turn can relieve pelvic pain

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