Pelvic Pain

Pelvic pain is pain felt in the lower abdomen, or pelvis. It can come on suddenly, or gradually. If it persists for longer than 6 months, then it is termed chronic pelvic pain.

What causes pelvic pain?

There are a number of reasons for pain in the pelvis in women who are not pregnant. These include:

Ovarian cysts

There are many types of ovarian cysts. Most are fluid-filled areas within the ovary which occur when the ovary doesn’t release an egg, and they often resolve without treatment. However, when cysts become quite large they can cause symptoms such as pelvic pain, frequency, heavy irregular periods, bloating or pain during intercourse. They can also cause pain if they burst or twist. Certain types of cyst don’t resolve on their own and need to be removed.

Endometriosis

This is a condition where the cells from the lining of the womb are in places other than in the uterine cavity, most commonly in the pelvis and on the ovaries. These areas cause inflammation and pain. Pain during the period and during intercourse are often also present. A keyhole procedure called a laparoscopy is usually performed to both confirm the daub oasis and treat the endometriosis. This is often followed by treatments to suppress the endometriosis and include hormone treatment or the mirena coil.

Period pain

Pain during the periods (dysmenorrhoea) is common and is normally mild. However, around 1 in 10 women have severe pain which affects day to day living. In these cases it may signify an underlying problem such as adenomyosis or endometriosis.

Ovulation pain (Mittelschmertz)

Painful ovulation is pain that occurs during ovulation. When the membrane covering the ovary stretches just before the egg is released, this can cause pain. Usually it lasts between minutes and a few hours, and doesn’t normally require any intervention.

Premenstrual Syndrome (PMS)

PMS encompasses many symptoms which typically begin 2 weeks before each period and can vary in nature each month. As well as pelvic pain, women can experience bloating, backache, headaches, weight gain, muscle and joint pain, nausea, and trouble sleeping. Emotional symptoms such as feeling upset, emotional, angry or irritable, crying, feeling anxious, tiredness and restlessness are all very common. There are various treatments which can be very effective.

Pelvic inflammatory disease (PID)

PID is an inflammation of the reproductive organs. It is caused by bacteria that travel into the uterus from cervix or vagina. It can be caused by sexually transmitted infections or by one of the bacteria which are normally present in the vagina after a procedure such as having a coil inserted. Apart from pelvic pain and backache, you can have irregular bleeding, vaginal discharge and a high fever.

What treatment do I need?

A thorough history and examination will often suggest the cause of the pain. In addition, blood tests, swabs and an ultrasound scan may be necessary. Treatment will vary widely depending on the cause of the pain, and can be discussed with your gynaecologist.