Pelvic Pain

The Apple, by Robin Lassiter

Pain in the lower abdomen is one of the most common symptoms causing a woman to seek care at the gynecologist. While often associated with reproductive organs, pelvic pain can have many sources including infection, inflammation or abnormality of the bladder, bowels, nerves, bones or muscles in the area. Therefore, a thorough evaluation is always warranted. Pelvic pain can be acute (happened suddenly and has been present for a short amount of time) or chronic (gradually got worst over the course of a few weeks to months). Keeping meticulous records of your symptoms is helpful for your treating doctor, especially if you have been experiencing pelvic pain for a long time. Noting what makes the pain better or worse, if the pain occurs at a certain time of day, associated with meals or bowel movements, if it stays at the same place or moves around…all such descriptive details are important and should be reported.

Possible causes of pain include: Urinary tract infections, sexually transmitted infection, endometriosis, ovarian cysts, kidney stones, constipation, and irritable bowel syndrome among many others. In order to narrow down the diagnosis, blood/urine tests and cultures, imaging via x-rays or ultrasound, or even surgery (diagnostic laparoscopy) may be recommended by your doctor.

Treatment modalities are as varied as the causes of pelvic pain. Infections are treated with antibiotics. Some pain syndromes associated with the menstrual cycle respond well to oral contraceptives. Pelvic floor physical therapy is often very helpful for women who have a musculoskeletal problem such as spasms. Chronic use of narcotic medication should not be considered long term as it does not address the cause of the pain.

As always, if your pain worsens and/or is accompanied by fever, vomiting or heavy vaginal bleeding, go to the nearest emergency room for prompt medical treatment and to rule out appendicitis, ectopic pregnancy, ovarian torsion or other potentially life threatening conditions. Fortunately, most causes of pelvic pain are not serious and can resolve with reasonably simple interventions.