Pelvic pain is experienced in the areas between the buttocks and below the belly button. If the pain lasts for a number of months and longer, it is termed as chronic pain. Women are more prone to pelvic pain that can lead to problems; it may also be a sign of and caused by an existing problem, which is usually the case. Pelvic pain is usually described by women as a dull pain or slight pressure located in the abdomen area below the navel, which may or may not be accompanied by sharp pains. At times, other symptoms might also accompany the pain, such as vaginal bleeding, vaginal discharge, or pain in the lower back.
The symptoms vary and include dull aches, severe and steady pains, intermittent pain, cramping, and heaviness in the deep pelvic region. Pain during urination, bowel movement, and intercourse, or while sitting for long periods of time, are also warning signs.
Causes of pelvic pain, especially in women
There may be a number of causes—located in the musculoskeletal system or urinary tract or gastrointestinal system—that lead to pelvic pain.
In this condition, the tissue lining of the womb grows outside the uterus and thickens, breaking down and bleeding each month just as it does during menstruation. However, this bleeding from an extended lining has no place to exit and remains in the abdomen, causing cysts and adhesions.
This uterine growth, which is usually non-cancerous, causes pressure and heaviness in the lower abdomen. Rarely, there may be pain when fibroids degenerate due to blood supply deprivation.
- Ovarian remnant
When the ovaries, uterus, or fallopian tubes are surgically removed, a small ovary piece might remain accidentally, causing painful cysts.
- Musculoskeletal problems
Pelvic pain can also be caused by problems of the musculoskeletal system, such as hernia, pelvic floor muscle tension, fibromyalgia, or pubic symphysis.
- Chronic pelvic inflammatory disease
If scarring occurs due to long-term infections, especially those transmitted sexually, it can cause pelvic inflammatory disease.
- Irritable bowel syndrome
Bloating, constipation, and diarrhea are symptoms of IBS, which can cause pelvic pressure and pain.
- Pelvic congestion syndrome
It is believed by some doctors that varicose-like enlarged veins can cause pelvic pain, but this has yet to be proven.
- Interstitial cystitis or painful bladder syndrome
Frequent urination urge along with recurring bladder pain and painful pelvic pain, especially when bladder is full, are symptoms of this condition.
- Psychological factors
Conditions such as depression, chronic stress, and physical or sexual abuse can cause pelvic pain, and stress invariably aggravates the condition further.
Ovarian torsion, ectopic pregnancy, rupture of an ovarian cyst, gynecologic cancer, appendicitis, and kidney stones may also be causes of pelvic pain.
These are the major causes of pelvic pain, which can be diagnosed via pelvic exam, lab tests, laparoscopy, ultrasound, and other imaging tests to rule out other conditions and make exact diagnosis.
The treatment involves medication, such as pain relievers, antibiotics, hormone treatment, and antidepressants. Physiotherapy, psychotherapy, trigger point injections, neurostimulation, laparoscopy, hysterectomy, and acupuncture are other treatment options to be considered in conjunction with lifestyle changes.