Pelvic Pain

Pelvic Pain area

Last Updated December 20th, 2021

Overview of pelvic pain

pelvic pain abdominal distensionPelvic pain conditions become very common in women after a certain age, especially in the post-menopausal phase. In most cases, it is closely associated with physiological and environmental factors. The symptoms may vary from mild to severe, depending on the intensity of the disease.

According to research findings by International Pelvic Pain Society, nearly 6-26% women are sufferers of chronic pelvic pain throughout the world. The pain of critical nature has also been found to be strong indicators of cancers in a few rare cases.

 

What is a pelvic pain?

Pelvic pain is defined as the persistent, burning pain felt in the pelvic region, particularly the groin which slowly radiates to the neighboring regions such as the lower back and the limbs. Depending on the intensity and duration of the pain, it can be of three types viz- acute, chronic and recurrent.

 

What are the causes of pelvic pain?

The following etiological factors may contribute to pain in the pelvic region-

  • Central and peripheral nervous systems: A particular neurological condition called visceral hyperalgesia results from abnormalities in visceral function and perception, which may gradually lead to severe nerve damage. This condition is normally observed after some surgery, mechanical trauma, inflammation, fibrosis, or infections. These collectively lead to the generation of “neuropathic pain” which is manifested as burning, piercing or shooting pain in the pelvic region.
  • EndometriosisIn this condition, acute inflammation of the endometrial tissue occurs due to plasma cell infiltration. This leads to pain in the pelvic region causing pain and cramps in lower abdomen and unexplained uterine bleeding.
  • Adenomyosis: In this case, the endometrial glands intrude into the uterine muscle (myometrium). Adenomyosis is manifested as pain in the pelvic region, with cramps, abnormal uterine bleeding and painful menstruation with cramps (dysmenorrhea).
  • Adhesions: Dense vascular adhesions cause enlargement of a particular organ that gives rise to pelvic pain. Two common cases pertaining to adhesions are- Residual Ovary Syndrome (remaining ovarian tissues after a surgery) and Trapped Ovary Syndrome (residual ovarian segments remain buried in adhesions). All these conditions lead to the pain of pelvic origin.
  • Cystitis: Interstitial cystitis can lead to chronic pain in the pelvis.
  • Pelvic congestion: Under certain conditions, pelvic vascular congestion is caused by expanded uterine and ovarian veins that cause a sluggish flow of blood through the veins causing pain in the pelvis.
  • Pelvic inflammatory diseases: Pelvic inflammatory diseases caused due to infections by Chlamydia species cause inflammation of the upper genital tract. This leads to lower abdominal tenderness and cervical tenderness and results in pelvic pain.
  • Ovarian disorders: Ovarian cysts (mainly corpus luteum cysts) and ovarian torsions (adnexal torsions) are two major contributors of pelvic pain.
  • Musculoskeletal problems: Musculoskeletal problems arising from a hernia or severe muscular damage may lead to pelvic pain. Pelvic organ prolapse may be observed in certain cases. In this condition, the patient experiences frequent muscle contraction and tightness within a particular band of muscles.
  • Gastrointestinal disorder: Bowel disorders such as diarrhoea, constipation and abdominal distension can lead to pelvic pain.
  • Urological problems: Renal dysfunctions triggered by kidney stones, ureteral calculi or urinary tract infections may cause chronic urological disorders leading to inflammation of the urinary tract, which is manifested as pain in the pelvic portion.

 

What are the main signs and symptoms?

Pelvic Pain areaPelvic pain symptoms are often confused with symptoms of other diseases. The following symptoms should be identified-

  • Burning pain or a dull ache in the groin and lower abdomen
  • Abdominal cramps before or after the menstrual period
  • Painful sexual intercourse
  • Pain during bowel movements and urination
  • Painful ovulation
  • Rectal bleeding
  • Lower back pain
  • Infertility
  • Abdominal distension
  • Bleeding in between consecutive menstrual cycles
  • A feeling of pressure, heaviness, and tenderness in the pelvis
  • Piercing pain after sitting or standing for a long time
  • Pain radiating to lower extremities from the groin
  • Weakness and fatigue

 

What are the different types of pelvic pain?

The pain of pelvic origin is broadly categorized into the following three classes-

  • pelvic pain kidney stonesAcute pain: This is the kind of the pain in the pelvis that normally lasts for less than three months. It is characterized by tissue damage and is induced by certain clinical conditions such as peritoneal irritation (characterized by distension and inflammation), excessive pressure on the walls of the pelvic structures and ischemic attacks. The causative factors are usually identifiable in this case and hence acute pelvic pain is curable on early diagnosis.
  • Chronic pain: This category of pain persists for about 6 months or more and is usually cyclic in nature. Non-cyclic pain may also be observed, which persists for 3 months or more. Irrespective of the duration, chronic pelvic pain disrupts normal activities of daily life. Chronic pelvic pain is normally observed after the age of 30. Laparoscopic evaluation becomes necessary in few of the critical cases. Chronic pelvic pain usually originates from musculoskeletal, neurological, gynecological and gastrointestinal.
  • Recurrent pain: Recurrent pain in the pelvis is basically a type of chronic pain occurring in a cyclic manner. It is usually irregular and intermittent in nature. It is caused due to certain clinical conditions such as Mittelschmerz (pain during ovulation), Dysmenorrhea (menstruation with abdominal pain and cramps) and Adenomyosis (embedded endometrial glands within myometrium). Recurrent pain is episodic in nature and can be cured via medications.

 

Diagnosis

Accurate diagnosis of pelvic pain of any kind is essential for the proper treatment of the disease. The following diagnostic tests are usually carried out-

  • Screening for infection: It is done to rule out possibilities of Chlamydia infections.
  • Transvaginal scanning and MRI: These are critical for identifying and analyzing adnexal masses, adenomyosis, and endometriosis.
  • Serum CA125 measurement: It is done to find the root cause of certain symptoms like abdominal bloating, loss of appetite, pelvic pain and frequent urination.

 

Treatment & Prevention

Adenomyosis 

Treatment 

  • Ibuprofen, an anti-inflammatory drug, if taken 1-2 days before the menstrual cycle starts, can help in reducing the blood flow and the severity of the pain.
  • Estrogen-progestin drug consumption can reduce heavy bleeding and pain.
  • In cases, when pain caused by Adenomyosis is severe, a hysterectomy is done to remove the uterus.

Menstrual cramps 

Treatment 

  • Over-the-counter pain relievers can be had 1-2 days before the menstrual cycle starts. These medications can be had for 2-3 days during the menstrual cycle or until the symptoms are gone. Prescribed NSAID’s (nonsteroidal anti-inflammatory drugs) can be consumed as well.
  • Hormonal birth control pills can help in reducing the severity of the pain felt during a menstrual cycle.
  • In cases where menstrual cramps occur due to another medical condition such as endometriosis or cysts, surgery may be required. The uterus is removed to relieve patients from menstrual cramps.

Prevention 

  • Maintain a healthy diet.
  • Maintain an ideal body weight.
  • Do not smoke.
  • Do not consume excessive amounts of alcohol.

Miscarriage 

Treatment 

  • If there are chances of a miscarriage, pregnant women will be advised to rest and abstain from any exercise and sexual intercourse till the discomfort subsides. Travel plans need to be postponed in case there is a high chance of a miscarriage.
  • If it has been proven that if the embryo has died, miscarriages are left to progress naturally. This tends to take 3-4 weeks. If it takes longer than the expected time, medical or surgical methods will be used to remove the embryo.
  • At times to speed up the process, medications will be prescribed to remove the pregnancy tissue along with the placenta. These medications can be given orally or they can be inserted into the body. Doctors recommend medication insertion as it is most effective.
  • Surgical procedures will be required in cases where there is an infection along with the miscarriage. A surgical procedure called suction dilation and curettage (D&C) will be conducted. Here the cervix is dilated and the tissue is removed.

Prevention 

  • Visit your doctor regularly.
  • Avoid smoking.
  • Do not consume alcohol.
  • Do not use illicit drugs.
  • Limit your caffeine intake.

Mittelschmerz 

Treatment 

  • Pain relievers can help ease the symptoms of mittelschmerz.
  • Birth control pills are prescribed to help ease the symptoms of this condition. These medications inhibit ovulation, thereby making sure that there is no pain felt.

Prevention

  • Use heating pads to help relieve pain.
  • Soak in a hot bath to reduce pain.
  • Do not consume alcohol.
  • Do not consume excessive amounts of spicy foods.

Facts

  • Mittelschmerz is derived from a German word meaning ‘middle pain.’ Mittelschmerz usually occurs 14 days prior to the next menstrual cycle.
  • Mittelschmerz is most common among women who are between the age group of 15-29 years. This condition is prevalent among colored and Hispanic women.

Facts

  • Adenomyosis is not the same as endometriosis. Adenomyosis is when endometrial cells exist and grow into the wall of the uterus. Endometriosis is when cells tend to plant in the regions outside the uterus.

Facts

  • 80% of miscarriages occur in women who are above the age of 35 years.
  • Women spend 3,500 days menstruating throughout their lifetime.
  • The term ‘period’ for the menstruation cycle was first used in 1822.

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Dos and Don'ts

Dos
  • Light exercise, this helps in relieving pain.
  • Consume fruits, vegetables, fish, and chicken; they provide energy and the essential vitamins and minerals required by the body.
  • Consume a lot of fluids, this helps keep the body hydrated.
Don'ts
  • Consume spicy food, as they tend to irritate the stomach and cause more pain.
  • Consume excessive caffeine; it tends to increase the risk of developing chronic pelvic pain.
  • Consume dairy products, this can increase the frequency of cramps and abdominal aches.

 

 

 

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Balneotherapy jacuzzi
5 things you didn’t know about balneotherapy and how you can do it at home Sauna baths have been popular since a long time. But how much more beneficial can balneotherapy be as…
GGt test
GGT – Gamma-Glutamyl Transferase Test GGT or gammaglutamyl transferase test is a liver function test that is used to detect the extent of…
LFT-test
Liver Function Test – LFT LFT or Liver Function Test is a blood test used to determine the levels of hepatic enzymes which…
apolipoprotein a1 test
Apolipoprotein -A1 (APO-A1) Test Apolipoprotein A-I (Apo-A1) constitutes 70% of protein content in high-density lipoprotein (HDL) and helps in lipid metabolism.
shiitake mushrooms healthy
What are Shiitake Mushrooms and why should you eat them? Shiitake Mushrooms are well known for their smoky and robust taste. However, did you know they are replete…
lose weight fast
12 easy and instant steps to successful weight loss Do you want to lose weight without losing your mind? Does weight loss always mean saying goodbye to…
nutritional yeast bread
Nutritional Yeast : How can a fungi culture be good for your body? Nutritional yeast: How a simple culture of fungi can transform your skin, digestion, immunity , and much more.…
Epley maneuver: Why is this the best protection from the symptoms of vertigo? Epley maneuver is an exercise that can treat the symptoms of benign paroxysmal positional vertigo (BPPV).  It was…
What to eat, what not to eat in the South Beach Diet? The South Beach Diet is one among the most popular weight loss programs that have been the talk…
Erythritol: A healthy sugar substitute or yet another marketing ploy? Erythritol is a popular choice of a healthy alternative sweetening agent in foods. But how healthy can a…
Carb Cycling: Weighing the pros vs the cons of this diet routine Completely discarding carbs from your life will do you more harm than good. Read more about carb cycling,…
Vitamin-D-blood-test
25-Hydroxy Vitamin D test 25-hydroxy Vitamin D test is a blood test used to measure the level of vitamin D in the…
myelogram
Myelography Myelography is an important diagnostic tool that is used to investigate and identify abnormalities in the spine and…
HSV-1_IGG
Herpes Simplex Virus I (HSV)-IgG Test Herpes simplex virus I(HSV)-IgG is an Immunoglobulin protein that acts as an antibody & stays in the blood…
Thyroid disorders
Thyroid Profile Thyroid profile is a panel of blood tests performed to check if an individual is suffering from any…
AUTOIMMUNE HEPATITIS liver
Hepatitis Profile A hepatitis profile or a hepatitis panel is a blood test that checks for markers of hepatitis infection…
Hepatitis A virus infected liver
Hepatitis A Virus (HAV) Total Blood test to look for IgM antibodies to know if you are infected with Hepatitis A virus (HAV),…
carrageenan seaweed
Carrageenan: How a simple seaweed extract could better your gut health & immunity Eat more ice cream to prevent cold and flu? –With carrageenan you get one simple seaweed extract that…
dance health benefits
5 unbelievable effects of dance on your overall health! You enjoy dancing, but did you know what else it does to your body? Dancing is not only…
Jack in the box fast food
Jack In the Box : The perils of surging fast food culture in the USA Jack in the Box - How a culture of fast-food can clog your arteries, weaken your heart, fatten…
Moringa drink
Moringa: This could be the most nutrient-dense food known to us! Moringa is a lush green tree brimming with over 90 essential nutrients required for a healthy mind and…
Kava: Is it the healthy substitute for alcohol you have been waiting for? Native to the beautiful South Pacific islands, Kava is a famous beverage rooted in the local culture. It…
How seitan proved to be a blessing in disguise for vegans worldwide Can only meat-eaters enjoy delicious juicy steaks and burgers? With seitan, the best meat substitute available today,even vegans…
Appendix pain: Recent findings on this not-so vestigial organ The exact function of the appendix is still not clear. Some consider it as an organ that once…
Surgery or home-remedy; what is the right way to treat a burn The treatment of a burn injury depends on its severity. You can save a life by offering the…
liver cleanse detox
14 go-to foods that are best for a complete natural liver detox Liver cleanse can be achieved by just choosing or avoiding certain types of food. Liver itself is a detoxifying…
Chest X-Ray A chest x-ray is a diagnostic test that uses x-rays to visualize the structures inside your chest. It…
Strep throat pain
Anti-Streptolysin-O Test The ASO or Anti-Streptolysin-O is a blood test designed to check for the presence of streptococcus bacterial infection…
phenytoin test
Phenytoin test Phenytoin is a drug that is administered mainly to epilepsy patients. The phenytoin blood test measures the level…
AHBC Igm
Anti-Hepatitis B Core Antigen (AHBc) IgM Anti-hepatitis B core antigen (AHBC) IgM is an investigative procedure to detect the presence of IgM antibodies in…
ureteroscopy
Ureteroscopy Ureteroscopy is the diagnostic procedure which is used for the detection of the kidney stones in addition to…
Unbelievable health benefits of gooseberries (and a few tasty recipes) Gooseberries are antioxidant-rich tasty fruits that can be easily added in daily diet to improve overall health and…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
piles fissure fistula
Allopathy vs homeopathy vs ayurveda treatment for piles, fissures, and fistula Read to know the best form of treatment among allopathy, homeopathy,or ayurveda for piles, fissures, and fistula
cancer facts
8 hard-hitting truths no one tells you about cancer Did you know that 1.5 million new cases of cancer are reported every year? Can second-hand smoking kill…