Pelvic Pain in Women

Center : Women Health Center

Article by : Dr. Jutaporn Uthaisan

Pelvic Pain in Women

Pelvic pain symptoms are often overlooked from many women. They may think that it is only general abdominal pain like they have when they are on their period. However, if the pelvic pain is acute, or having more crucial pain during their monthly period, and often pain without any cause until you cannot do your normal activities; it can be a sign of some gynecological diseases.

What is Pelvic Pain in Women

Pelvic pain in women, from the navel to the upper edge of the pelvis. There are many important organs in this area that can cause pain in the lower abdomen, such as the uterus and both fallopian tubes and both ovaries and the bladder in front of the uterus. There are both small and large intestines that are constantly moving and squeezing. The appendix is ​​located on the right side, slightly below the navel. There are also two ureters in the posterior abdominal wall. Importantly, all such organs can cause pain in the lower abdomen. It can be caused by inflammation, injury, tumors, or cancer. even congenital abnormalities, etc.

Pelvic Pain in Women Symptoms

Pelvic pain in women is the pain under navel to pubis areas. It can be acute and chronic pain. It may or may not associate with menstrual period.

What kind of pain that should see doctor for further diagnosis?

  • Acute and crucial pain
  • The pain does not get better after taking painkillers.
  • Chronic pain that affects habitual activities for more than 6 months.
  • Pain with other symptoms such as: fever, nausea, vomit, burning urine, have a history of infertility
  • Crucial pelvic pain during menstrual period

Chronic Pelvic Pain in Women

The pain does not improve after taking painkillers; and has chronic pain that interferes with daily life for more than 6 months.

When to See a Doctor?

You should see a doctor immediately, if sudden severe pain in the lower abdomen increases or lower abdominal pain along with other symptoms including:

  • Menstrual pain or cramping during menstruation and getting progressively worse
  • Blood, spotting or vaginal discharge
  • Pain while urinating or difficulty urinating
  • Constipation or diarrhea
  • Bloating, indigestion, or belching
  • Bleeding during excreting
  • Pain during sex
  • Fever or chills
  • Pain in the hip or groin area

Causes of Pelvic Pain in Women

1. Endometriosis

Endometriosis is the most common disease found when having a pelvic pain during the period especially for women who used to be infertile. The symptoms are chronic pain more than 6 months, pain during sexual intercourse, nausea, vomit, flatulence during period. Chocolate cyst is also included in endometriosis diseases.

2. Myoma uteri

Myoma uteri can cause pelvic pain especially when the tumor is big until it settles the organ nearby. Tumor twisting can make the crucial pain, pain during period, or having necrosis within tumor.

3. Ovarian tumor

Twisting, breaking, leaking of the cyst can cause acute pain. It may have blood within the abdomen or getting infected. If the cyst is very big, it may cause congestion and make feeling full quickly when eating.

4. Menstrual pain and cramps

Menstrual cramps are pain caused by uterine contractions. Often characterized by non-rhythmic pain, frequent pain, uterus contracts 4-5 times in 10 minutes, usually starting with mild pain first and gradually increasing in intensity.

5. Ovulation

Feeling pain in the lower part of the abdomen, be it left or right depending on the month of ovulation, which will affect each side every month including chest pain, weak legs, sometimes a little bleeding from the vagina for 1-2 days.

6. Cystitis or urinary tract infections

There will be pain in the lower abdomen while urinating, there may be a severe pain in a twisting or twitching style. Along with symptoms of urination that is not the most, dripping or seeping out again.

7. Appendicitis

Pain on the right lower abdomen increases when moving. Pain subsides when bending still, high fever and increased abdominal pain. Abdominal pain occurring in a position below the epigastrium or severe abdominal pain in the lower abdomen, especially on the right lower abdomen.

8. Uterine fibroids

Abdominal pain is often caused by changes in the tumor, such as the size of the tumor causing inadequate blood supply and thus ischemia. Abdominal pain due to the tumor pressing on other organs until it causes severe pain. It is like having a heavy lump in the abdomen.

9. Urinary stones

Difficulty urinating, burning or stinging sensation, blood in the urine, abdominal pain could be signs of bladder stones, caused by the retention of waste in the body. When urine is not completely eliminated, urine remains in the bladder until the buildup occurs and then gradually grows into gallstones

10. irritable bowel syndrome

Irritable bowel syndrome is a common condition. It is a disease that does not cause serious harm, but causes a feeling of discomfort at work and in daily life. Most common symptoms of abdominal pain to visit a doctor. Especially pain in the lower abdomen with abdominal discomfort. The symptoms are associated with abnormal bowel movements.

Pelvic Pain in Women Diagnosis

Your doctor will ask about your symptoms. Then check the body for areas that may be the cause of the illness; or the doctor may send additional tests based on the assumption of the cause of the illness using the following methods:

  1. Taking patient’s history and health check-up such as a blood test to detect ovarian cancer.
  2. Pelvic Examination or screening for cervical cancer. Your doctor will use a vaginal speculum and then a pap-smear.
  3. Ultrasound; using a device that sends sound waves to create an image of the internal organs on the instrument screen. It is for the doctor to detect abnormalities of various internal organs.
  4. Hysteroscopy; it is to use an endoscopy to look at pathology in the pelvic area, check for abnormalities in the uterus by inserting a camera through the vagina to examine the inside of the uterus.

Treatment for Pelvic Pain in Women

  1. Painkillers such as paracetamol or ibuprofen. For pain in the abdomen before menstruation or during menstruation. However, if you do not know the exact cause, you should see a doctor for examination and treatment to determine the underlying cause.
  2. Hormonal treatment is used for abdominal pain in women due to menstruation. The doctor will determine the appropriate type and dose of medication.
  3. Laparotomy or Laparoscopic Surgery if the patient has severe symptoms and there is a cause of disease due to growths of the endometrium in the wrong place or tumors in various organs that have not improved with drug treatment. However, the doctor will re-diagnose whether surgical treatment is necessary or not. The surgery can be performed in 2 ways, namely laparotomy and laparoscopic surgery.

Laparotomy Laparoscopic Surgery
Advantages Suits for the big tumor case or spread to other organs
  • Suits for endometriosis case.
  • Small wound
  • Faster in recovery time
  • Lose little blood
  • Less pain after surgery
  • More blood loss
  • Can have more fibrosis from surgery
  • Not for cases that have abdominal infection
  • Cannot use for emergency case

Pelvic Pain in Women Conclusion

If you have a pelvic pain whether acute or chronic and persist by primary treatment; you should see the doctor immediately. Regular yearly health check-up can help screen gynecological diseases. If it is found and treated quickly, it can help you get back to good health.

Why must come to Nakornthon?

Women Health Center offers comprehensive health care services for women of all ages; from health examination to diagnosis, prevention, treating women related diseases. All by specialists in the field, providing consulting services with technology to help diagnose diseases; in order to increase safety and treatment efficiency. It is done with understanding and concern for women health.

Dr.Jutaporn Uthaisan Dr.Jutaporn Uthaisan

Dr.Jutaporn Uthaisan
Obstertrics and Gynaecology/Gynaecological Oncology
Women Health Center

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