Because pelvic pain has a number of causes, finding the source can be a long and complex process. Even when there is no specific cause found, there are treatments that can help.
Acute Pelvic Pain
Acute (or sharp) pain starts suddenly and often has a single cause. This type of pain may be a warning that something is wrong. Some causes of acute pelvic pain include:
- An infection of your uterus, fallopian tubes, or ovaries; this condition is called pelvic inflammatory disease (PID).
- An infection of the urethra, bladder, or kidneys
- Ovarian cysts - may go away on their own or may need to be surgically removed
- Ectopic pregnancy
You should track your symptoms and talk openly with your doctor whenever you feel acute pelvic pain. Treatment may be as simple as taking antibiotics. In some cases, surgery may be required. Only your doctor can determine the cause of the pain and the course of action to resolve it.
Chronic Pelvic Pain
Chronic pelvic pain occurs over a long period of time, either constantly or coming and going. Constant chronic pain may be caused by more than one problem in more than one area of the body. In all cases, carefully track your symptoms and speak with your doctor to help uncover the cause of your pelvic pain.
Dyspareunia
Pain during sexual intercourse, known as dyspareunia, is fairly common, with nearly two out of three women experiencing it at some point. The pain can range from mild to severe in the vaginal region or deep inside your body. This can have both physical and emotional causes, and it’s important to find the cause of your pain because you may have problems that need medication, surgery, or counseling.
Dysmenorrhea
Although mild pain is common during your menstrual period, some women have pain severe enough to keep them from their normal activities. This type of menstrual pain is called dysmenorrhea.
Primary dysmenorrhea is pelvic pain that is the result of having your period and begins soon after you start menstruating. Secondary dysmenorrhea is menstrual pain that has another cause in addition to menstruation. Pain often begins earlier in the menstrual cycle and usually lasts longer than normal cramps. Some common causes of secondary dysmenorrhea are endometriosis, uterine fibroids, and pelvic inflammatory disease.
There are effective ways to treat dysmenorrhea. In addition to your doctor prescribing or suggesting medication to help, other ways to find relief from discomfort include:
- Apply heat to your abdomen
- Get plenty of sleep before and during your period
- Exercise regularly
- Perform relaxation exercises
- Have sex, as orgasms can relieve cramps in some women
Endometriosis
If menstrual cramps worsen over time or remain strong beyond the first one or two days, they may be caused by endometriosis. Endometriosis occurs when tissue similar to the lining of the uterus is found outside the uterus, most often on the ovaries, fallopian tubes, and other pelvic structures. This condition can cause pain before and during the menstrual cycle and, if severe, can lead to infertility. Treatment for endometriosis depends on the extent of your condition, your symptoms, and whether or not you want to have children. Your doctor can determine whether medication, surgery, or both are needed.
Adenomyosis
Adenomyosis occurs when the lining of the uterus extends into the muscle wall of the uterus. It can cause painful menstrual cramps, pressure and bloating in the lower abdomen before menstrual periods, and more bleeding during periods. Your doctor can help you control your symptoms with medication and surgery in some cases.
Mittelschmerz or Ovulation Pain
Pain that is felt around the time you ovulate is sometimes called mittelschmerz (German for "middle pain"). This pain can range from a mild pinch or twinge to something more severe. In some women, it occurs every month and in others, it occurs once in a while. Over-the-counter medications can usually help relieve your ovulation pain.
Diagnosis & Treatment of Pelvic Pain
The first step to diagnosing your pelvic pain is to undergo a pelvic exam. Your doctor may also recommend laboratory tests and imaging studies. Depending on the nature of your problem and its possible causes, your doctor may consult with or refer you to a specialist for care.
Your doctor will ask detailed questions about your health history and may ask you to keep a Pain Journal. In your Pain Journal, you record when you feel pain, how the pain feels, and how long the pain lasts. Although keeping a Pain Journal may seem complex and time consuming, it is the best way to help your doctor determine what is causing your pelvic pain.
Your Pain Journal
When do you feel pain?
- Time of day
- Certain times of your menstrual cycle
- Before, during, or after certain activities
Describe the pain and note how long it lasts.
- Is it sharp or a dull ache?
- Does it come in waves or is it steady?
- How intense is the pain?
- Does it always occur in the same place?
- What makes it better or worse?
Treating Pelvic Pain
Once the cause of your pelvic pain is determined, your doctor will design a treatment plan to either manage or alleviate the cause of the pain. Possible treatments include:
- Prescribed or over-the-counter medications
- Surgery
- Heat therapy and muscle relaxants
- Physical therapy
- Nutrition therapy
- Biofeedback
- Acupuncture
