What are the common causes of pelvic pain in women?

The more common causes of lower abdominal and pelvic pain are summarised in Table 23.1. Physical pain may arise from the vagina, cervix, the uterus, the ovaries or the Fallopian tubes (Figure 02-01). The pain can also be of non-gynaecological origin arising from the bowel, bladder or the musculo-skeletal system.

Figure 02-01

Table 23.1 The more common causes of pelvic pain and lower abdominal pain.

Organ

 Disorder / Disease

Vagina

Vaginitis

Prolapse

Cervix

Cervicitis

Uterus

Fibroids

Intrauterine contraceptive device

Endometrial polyp

Fallopian tubes

Ectopic pregnancy

Pelvic inflammatory disease

Ovaries

Endometriosis

Mittelschmerz (Ovulation pain)

Ovarian cyst

Peritoneum

Endometriosis

Pelvic congestion

Peritonitis

Retrograde menstruation

Bowel

Appendicitis
  Crohn's disease

Constipation

Diverticulitis

Gastroenteritis (Acute diarrhoea and vomiting)
  Irritable bowel syndrome

Ulcerative colitis

Bladder / urinary tract

Renal colic (kidney stones)
  Urinary tract infection

Musculo-skeletal system

Ligament and muscle pain.

Psychological

There are times when despite careful investigation, a physical explanation for the pelvic pain cannot be found. Sometimes the pain may be psychosomatic (a subconsciously mediated physical manifestation of a mental disorder).


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