Pelvic Pain

In this article we explain the possible causes of Lower Abdomen (Pelvis) Localized Pain.  Many women

pelvic pain

Inflammation, endometriosis, pelvic adhesions but also urinary and intestinal diseases can cause pelvic pain in women.

experience Pelvis Pain at least once in their life, both acutely or chronically and symptoms length it is very important to identifying the cause.

ACUTE PELVIC PAIN (of short duration) can also be particularly intense and generates a lot of apprehension. Often requires urgent medical consultation. During this kind of pain, pay attention to these questions:

  • Are you in a menstrual period?
  • Do you have diarrhea or constipated?
  • Do you urinate normally, or more often with pain?
  • Did you have a sexual encounter shortly before the pain beginning?
  • Are you in the ovulation period?
  • Did you take a drug?
  • Does the pain persist for more than 30 minutes from the onset?
  • Does the pain is constant or growing or has an erratic trend?
  • Do you have a missed period or are you pregnant?

Answering these questions will help you to be more aware of the situation and will be of great help to your doctor with the necessary physical examination will in most cases get quickly to a rapid diagnosis.

But we see the major causes of acute pelvic pain:

  • Intestinal Colic complications or intestinal pathologies such as pre-existing Diverticulitis, inflammatory bowel disease;
  • Cystitis;
  • Appendicitis;
  • Ovarian Cyst torsion or breakage;
  • Ruptured Follicle and possible abdominal bleeding;
  • Dyspareunia;
  • Dysmenorrhea (also more correctly called Algomenorrhea);
  • Abortion threat or pregnancy placental complications;
  • Bleeding (colliquation) of a uterine fibroid or torsion of its aventual pedicles.

Note: as you have read the causes may be very different and not always of gynecological origin. Sometimes it is necessary to use haematochemical and instrumental investigations: CBC, urinalysis, pelvic (endovaginal when possible) and abdominal ultrasounds are the first instances.

CHRONIC PELVIC PAIN may present with an acute episode or with mild, intermittent or sub-continuos symptoms. Often it is less alarming to the patient and does not determine acute exacerbations. Frequently, it leads to a delayed medical consultation.

When you warn a long time chronic pain at the lower abdomen (pelvis), beware if:

  • The pain is associated or arising in connection with intestinal or urinary disorders;
  • At the same time are noticed weakness or weight loss;
  • Abdomen shows changes (for example, it is more swollen);
  • Somehow there is an association or exacerbation with menstruation or sexual intercourse;
  • At the same time it is started to take medication;
  • A previously trauma or a surgery occurred.

Chronic pelvic pain is certainly more insidious and has very different causes; among these we mention the most frequent in women:

  • Bowel diseases;
  • Endometriosis;
  • Diseases of the urinary system;
  • Pelvic Inflammatory Disease (PID);
  • Ovarian Cysts;
  • Uterine fibroids;
  • Gynecological tumors;
  • Others Abdominal Cancers.

A modest chronic pain should never be underestimated. In these cases, there are numerous investigations and they are established after consultation with the Doctor. In addition to the most common blood tests may be necessary to investigate about infectious disease. Endoscopy, radiology and assessment of tumor markers may be useful in the differential diagnosis.

When there is a gynecological orientation, gynecological visit is certainly the most important moment for diagnostic purposes. Sometimes next to it are particularly useful;

  • CBC (Complete Blood Count), ESR (erythrocyte sedimentation rate) , CRP (C-Reactive Protein), urinalysis and urine culture, occult blood in faecal research (eventual parasites research)
  • Pelvic Ultrasound;
  • Vaginal swab;
  • CA 125 and HE4 (the latter in the presence of ovarian cysts);
  • Nuclear Magnetic Resonance (RMN) in the presence of masses of uncertain origin or in the preoperative phase (staging);
  • Laparoscopy.

Endometriosis is very common and particularly affects young women in their reproductive years. It is also among the leading causes of infertility. My advice is that even young women must always give due considerations to it.

PELVIC PAIN THERAPEUTIC ASPECTS are not among the aims of this article. You can find more informations about single pathologies in the other sections of this site.

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Filiberto Di Prospero
Medical Doctor, Consultant in Gynecology and Obstetrics, Endocrinology and Metabolism. Director of Gynecologic Endocrinology Unit at Civitanova Marche General Hospital (Italy). Private clinics in Civitanova Marche, Rome and Milan.
Filiberto Di Prospero

Filiberto Di Prospero

Medical Doctor, Consultant in Gynecology and Obstetrics, Endocrinology and Metabolism.
Director of Gynecologic Endocrinology Unit at Civitanova Marche General Hospital (Italy).
Private clinics in Civitanova Marche, Rome and Milan.

 

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