Pelvic pain is pain that affects the lower part of the abdomen (the area between the belly button and groin). Pelvic pain is a general symptom that may be caused by everything from menstrual cramps to a ruptured ovarian cyst. While common, the origins of pelvic pain should always be examined.
Pelvic pain can be described as
- Sudden sharp pain in the pelvic area that is stabbing in nature
- Cramping pain that lingers around for a long period of time
- Pelvic pain that comes and goes
Sharp, sudden pelvic pain
Extreme pain in the pelvic area that comes on suddenly requires urgent medical attention. It may be a sign of a ruptured ovarian cyst, an ectopic pregnancy or an infection. All of these medical conditions must be treated urgently at a hospital or medical clinic.
Constant, cramping or dull pain
Pelvic pain that lingers around for weeks or months should always be investigated. Conditions such as endometriosis, fibroids or pelvic inflammatory disease (PID) may cause this type of pain. Other causes include endometrial polyps or cancers of the reproductive tract.
Common causes of pelvic pain
Common causes of pelvic pain include the following
- Fibroids
- Endometriosis
- Pelvic inflammatory disease
- Ovarian cysts
Pelvic inflammatory disease
Pelvic inflammatory disease (PID) occurs after an infection of a woman's reproductive organs in places such as the uterus, fallopian tubes or ovaries. PID is often caused by a sexually transmitted infection (STI) like chlamydia or gonorrhea.
PID is a serious medical condition that must be treated as soon as possible. Left untreated, PID can lead to long term complications with infertility.
Symptoms of PID
- Pain in the lower abdomen
- A high temperature
- Symptoms of an STI (i.e. unusual discharge from the vagina)
- Pain and/or bleeding during intercourse
- Burning sensation when passing urine
- Bleeding between periods
Risk factors for PID
Women are more likely to get PID if
- They are infected with an STI that goes untreated
- Have more than one sexual partner
- Have have been diagnosed with a PID before
Diagnosis and treatment
PID can be diagnosed by your doctor after they take a full medical history and carry out a physical examination. Treatment usually involves a course of antibiotics which at times may need to be administered intravenously (IV) and in the hospital.
It is important to see your doctor immediately if these symptoms occur because prompt treatment is mandatory.
Ovarian cysts
Ovarian cysts are fluid-filled sacs that are found in the ovaries. Most ovarian cysts are harmless and will disappear on their own but in some cases, cysts may become extremely large in size and start to cause symptoms. They may rupture or develop worrying signs that need to be investigated.
Symptoms of a cyst
- Pelvic pain that is dull or sharp
- A sensation of fullness or heaviness in the abdomen
- Difficulty passing urine or frequent need to urinate
- Difficulty emptying the bowels
- Feeling of fullness after only eating a small amount
- Pain during intercourse
- Bleeding in between periods
Types of ovarian cysts
The following are different types of ovarian cysts that may occur
- Functional cysts : Functional cysts are non-cancerous (benign) and are usually harmless. Functional cysts can sometimes cause symptoms of pelvic pain but most will disappear in a few months without treatment.
- Pathological cysts : Pathological cysts are cysts that are abnormal. They are not related to the menstrual cycle and always require further investigation by a doctor. Pathological cysts include: dermoid cysts, cystadenomas and endometriomas. Pathological cysts share many of the same symptoms as functional cysts. That is why it is important to see a doctor if the symptoms mentioned above are experienced. Formal diagnostic testing is the only way to determine whether a cyst is harmless or not.
- Ruptured ovarian cyst : Although rare, a ruptured ovarian cyst is a medical emergency. A ruptured cyst can cause sudden, intense abdominal pain and internal bleeding. Any sudden and severe pain of the abdomen or pelvis requires urgent medical attention.
Diagnosis
Your doctor may be able to detect the presence of a cyst on routine pelvic examination. An ultrasound scan may be required to formally determine the type of cyst that has been found.
Treatment
Treatment of a cyst will depend on its size, appearance, the presence of symptoms and the type of cyst that has been found.
Because the majority of cysts disappear after a few weeks or months, your doctor may take what is called a watch-and-wait approach to see how the cyst behaves. To do this, they will recommend a repeat ultrasound test in a few weeks or months to check your condition.
A cyst that is not going away on its own or that is causing aggressive symptoms may be treated with birth control pills or a laparoscopy (surgical removal of the cyst).
If more worrying features of the cyst are found then more detailed treatment options will be discussed.
