Pelvic Pain

Pelvic pain is pain below the belly button and located between your hips. Acute pain may last a few hours or days. Chronic pelvic pain may last weeks and months. The cause may be different for different types of pain. The pain may be dull or sharp, mild or severe and can interfere with your daily activities. Write down and tell your caregiver:

  • Exactly where the pain is located.

  • If it comes and goes or is there all the time.

  • When it happens (with sex, urination, bowel movement, etc.)

  • If the pain is related to your menstrual period or stress.

Your caregiver will take a full history and do a complete physical exam and Pap test.

CAUSES

  • Painful menstrual periods (dysmenorrhea).

  • Normal ovulation (Mittelschmertz) that occurs in the middle of the menstrual cycle every month.

  • The pelvic organs get engorged with blood just before the menstrual period (pelvic congestive syndrome).

  • Scar tissue from an infection or past surgery (pelvic adhesions).

  • Cancer of the female pelvic organs. When there is pain with cancer, it has been there for a long time.

  • The lining of the uterus (endometrium) abnormally grows in places like the pelvis and on the pelvic organs (endometriosis).

  • A form of endometriosis with the lining of the uterus present inside of the muscle tissue of the uterus (adenomyosis).

  • Fibroid tumor (noncancerous) in the uterus.

  • Bladder problems such as infection, bladder spasms of the muscle tissue of the bladder.

  • Intestinal problems (irritable bowel syndrome, colitis, an ulcer or gastrointestinal infection).

  • Polyps of the cervix or uterus.

  • Pregnancy in the tube (ectopic pregnancy).

  • The opening of the cervix is too small for the menstrual blood to flow through it (cervical stenosis).

  • Physical or sexual abuse (past or present).

  • Musculo-skeletal problems from poor posture, problems with the vertebrae of the lower back or the uterine pelvic muscles falling (prolapse).

  • Psychological problems such as depression or stress.

  • IUD (intrauterine device) in the uterus.

DIAGNOSIS

Tests to make a diagnosis depends on the type, location, severity and what causes the pain to occur. Tests that may be needed include:

  • Blood tests.

  • Urine tests

  • Ultrasound.

  • X-rays.

  • CT Scan.

  • MRI.

  • Laparoscopy.

  • Major surgery.

TREATMENT

Treatment will depend on the cause of the pain, which includes:

  • Prescription or over-the-counter pain medication.

  • Antibiotics.

  • Birth control pills.

  • Hormone treatment.

  • Nerve blocking injections.

  • Physical therapy.

  • Antidepressants.

  • Counseling with a psychiatrist or psychologist.

  • Minor or major surgery.

HOME CARE INSTRUCTIONS

  • Only take over-the-counter or prescription medicines for pain, discomfort or fever as directed by your caregiver.

  • Follow your caregiver's advice to treat your pain.

  • Rest.

  • Avoid sexual intercourse if it causes the pain.

  • Apply warm or cold compresses (which ever works best) to the pain area.

  • Do relaxation exercises such as yoga or meditation.

  • Try acupuncture.

  • Avoid stressful situations.

  • Try group therapy.

  • If the pain is because of a stomach/intestinal upset, drink clear liquids, eat a bland light food diet until the symptoms go away.

SEEK MEDICAL CARE IF:

  • You need stronger prescription pain medication.

  • You develop pain with sexual intercourse.

  • You have pain with urination.

  • You develop a temperature of 102° F (38.9° C) with the pain.

  • You are still in pain after 4 hours of taking prescription medication for the pain.

  • You need depression medication.

  • Your IUD is causing pain and you want it removed.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You develop very severe pain or tenderness.

  • You faint, have chills, severe weakness or dehydration.

  • You develop heavy vaginal bleeding or passing solid tissue.

  • You develop a temperature of 102° F (38.9° C) with the pain.

  • You have blood in the urine.

  • You are being physically or sexually abused.

  • You have uncontrolled vomiting and diarrhea.

  • You are depressed and afraid of harming yourself or someone else.