Pelvic pain

An overview of pelvic pain in the context of medical education

Pelvic Pain

An endometrioma, a type of ovarian cyst, can be a cause of pelvic pain.

Pelvic pain is a common symptom experienced by individuals, particularly women, and can arise from a variety of causes. It is defined as pain that occurs in the lower abdomen and pelvis, and can be acute or chronic in nature. Understanding the etiology, diagnosis, and management of pelvic pain is crucial for medical professionals, especially those specializing in gynecology and urology.

Causes

Pelvic pain can be attributed to several potential causes, which can be broadly categorized into gynecological, urological, gastrointestinal, musculoskeletal, and psychological origins.

Gynecological Causes

• Endometriosis: A condition where tissue similar to the lining inside the uterus grows outside the uterus, often causing severe pain.
• Ovarian cysts: Fluid-filled sacs within or on the surface of an ovary, such as endometriomas, which can cause pain and discomfort.
• Pelvic inflammatory disease (PID): An infection of the female reproductive organs, often resulting from sexually transmitted infections.

Urological Causes

• Urinary tract infection (UTI): An infection in any part of the urinary system, which can cause pelvic pain and discomfort.
• Interstitial cystitis: A chronic condition causing bladder pressure and pain, often mistaken for a UTI.

Gastrointestinal Causes

• Irritable bowel syndrome (IBS): A common disorder affecting the large intestine, causing cramping, abdominal pain, and changes in bowel habits.
• Appendicitis: Inflammation of the appendix, which can cause severe pain in the lower right abdomen.

Musculoskeletal Causes

• Pelvic floor dysfunction: A condition where the muscles and tissues supporting the pelvic organs become weak or tight, leading to pain.
• Hernia: A condition where an organ pushes through an opening in the muscle or tissue that holds it in place, potentially causing pain.

Psychological Causes

• Depression and anxiety: These mental health conditions can manifest as physical symptoms, including pelvic pain.

Diagnosis

Diagnosing the cause of pelvic pain involves a comprehensive approach, including a detailed medical history, physical examination, and diagnostic testing.

Medical History

A thorough medical history should be obtained, focusing on the onset, duration, and characteristics of the pain, as well as any associated symptoms.

Physical Examination

A physical examination, including a pelvic exam, is essential to assess for any abnormalities or tenderness in the pelvic region.

Diagnostic Testing

• Ultrasound: A non-invasive imaging technique used to visualize the pelvic organs and identify any abnormalities such as cysts or fibroids.
• Laparoscopy: A surgical procedure that allows direct visualization of the pelvic organs and can be used to diagnose conditions like endometriosis.
• Blood tests: To check for signs of infection or other underlying conditions.

Management

The management of pelvic pain depends on the underlying cause and may involve a combination of medical, surgical, and psychological interventions.

Medical Management

• Analgesics: Pain relief medications such as NSAIDs or acetaminophen.
• Hormonal therapy: Used in conditions like endometriosis to reduce pain and suppress the growth of endometrial tissue.

Surgical Management

• Laparoscopic surgery: May be indicated for conditions like endometriosis or ovarian cysts that do not respond to medical treatment.

Psychological Management

• Cognitive behavioral therapy (CBT): Can be beneficial for patients with chronic pelvic pain associated with psychological factors.

Related pages

• Endometriosis
• Ovarian cyst
• Pelvic inflammatory disease
• Urinary tract infection
• Irritable bowel syndrome