- 1 Pelvic Pain. Is this a common problem?
- 2 What are the common causes of pelvic pain in women?
- 3 What are the more common gynaecological causes of pelvic pain?
- 4 What are the more common non-gynaecological causes of pelvic pain?
- 5 What are primary and secondary dysmenorrhoea - painful periods?
- 6 What is retrograde menstruation?
- 7 How can dysmenorrhoea - painful periods be treated?
- 8 What are ovarian cysts?
- 9 How do ovarian cysts cause pain?
- 10 How are ovarian cysts diagnosed?
- 11 How are ovarian cysts treated?
- 12 I think I may be pregnant and I have some pelvic pain. What should I do?
- 13 What is pelvic inflammatory disease and how can it be treated?
- What is Mittelschmerz
FIBROIDS
- 14 What are fibroids?
- 15 I have fibroids. What difficulties might they cause for me?
- 16 How are fibroids diagnosed?
- 17 How could my fibroids be treated?
ENDOMETRIOSIS
- 18 What is endometriosis?
- 19 How prevalent is endometriosis?
- 20 What causes endometriosis?
- 21 How can my endometriosis be treated?
- 22 How can my doctor determine the cause of my pelvic pain?
- 23 What investigations might be recommended by my gynaecologist to investigate my pelvic pain?
- 24 What is laparoscopy?
- 25 What are pelvic adhesions?
- 26 I have chronic pelvic pain. Could this be related to adhesions?
- 27 What is uterine retroversion (retroverted uterus)
- 28 Does a retroverted uterus cause symptoms?
- 29 How is a retroverted uterus treated?
- 30 What is pelvic congestion?
- 31 What causes pain associated with sexual intercourse (dyspareunia)
- 32 How can painful sexual intercourse (dyspareunia) be treated?
- 33 What is a pelvic mass?
IRRITABLE BOWEL SYNDROME - IBS
How prevalent is pelvic pain?
Pain is the most frequent reason for patients to seek medical advice and pelvic pain is a common reason for gynaecological consultation. Pelvic pain may be acute (sudden onset), chronic (long-standing) or recurrent (intermittent).
Related Medical Abstracts - Click on the paper title:-
- Chronic pelvic pain in New Zealand: prevalence, pain severity, diagnoses and use of the health services. (2004-01)
- Epidemiology of chronic pelvic pain. (2001-01)
- Prevalence and incidence of chronic pelvic pain in primary care: evidence from a national general practice database. (1999-01)
- Patterns of diagnosis and referral in women consulting for chronic pelvic pain in UK primary care. (1999-02)
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.
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 |
|
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.
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).
What are the common causes of gynaecological pelvic pain?
Dysmenorrhoea (pain associated with menstruation) is the commonest type of gynaecological pelvic pain in young women. Pain may occur at the time of ovum (egg) release about 14 days before the next period is due; this pain is called mid-cycle pain or Mittelschmerz. Cysts (fluid filled sacs) within the ovaries occur frequently and indeed naturally throughout the reproductive years; these may be called physiological or functional cysts. Sometimes, bleeding may occur into a physiological cyst resulting in acute pain. Pelvic pain may be an indication of a problem during early pregnancy (Miscarriage;12.23).
Other gynaecological causes of pelvic pain include pelvic inflammatory disease (Q 20. 2), fibroids (14) and endometriosis (18). Utero- vaginal prolapse (1) may cause a dragging pelvic ache or pain.
Related Medical Abstracts - Click on the paper title:-
- Chronic pelvic pain: the occurrence of interstitial cystitis in a gynecological population. (2005-01)
- The prevalence of interstitial cystitis, endometriosis, adhesions, and vulvar pain in women with chronic pelvic pain. (2005-02)The evil twins of chronic pelvic pain syndrome: endometriosis and interstitial cystitis. (2002-01)
- Criteria that indicate endometriosis is the cause of chronic pelvic pain (1998)
What are the more common non-gynaecological causes of pelvic pain?
- Constipation is probably the commonest cause of pelvic pain.
- Many patients have irritable bowel syndrome - IBS (34). Typically there is a story of intermittent diarrhoea and constipation.
- Infection in the urinary tract (e.g. cystitis) is another common cause of lower abdominal and pelvic pain. If a "mid-stream urine" sample shows evidence of infection, the problem should respond to an appropriate antibiotic.
- The musculo-skeletal system (the bones, muscles, tendons and joints) may be the source of pain in the pelvic area.
This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.
I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.
The aim of this web site is to provide a general guide and it is not intended as a substitute for a consultation with an appropriate specialist in respect of individual care and treatment.
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