Pelvic pain is one of the most difficult things to properly diagnose. This is mostly because chronic pelvic pain is hardly ever the result of one individual problem. On the contrary, many individuals suffer from several different conditions, each of which contribute to the overall pain. Because of this, treating just one cause will not do much in the way of treatment. Instead, the patient will need to find the perfect treatment that will target all of the current conditions consecutively. However, before an individual can treat their condition, they first have to identify the symptoms, and learn how they are diagnosed for treatment.
Definition & Facts
Pelvic pain is defined as pain occurring in the lower region of the abdomen and pelvis. Although pelvic pain generally refers to the pain in a woman’s internal reproductive system, pelvic pain can occur in men, as well.
The intensity and frequency of the pelvic pain is dependent solely on the cause. Sometimes the pain can occur suddenly, with sharp brief stints. This is known as acute pelvic pain. While other times it can happen over a long period of time, commonly referred to as chronic pain.
Any constant or intermittent pain, that lasts for more than a few months is diagnosed as chronic pelvic pain. Eventually the pelvic pain may become more severe and radiate further, throughout the patient’s lower back, buttocks, and thighs. Although at other times, the pain may subside, and become only noticeable during urination or sexual activity.
With that being said, pelvic pain can actually arise from issues anywhere within the digestive, reproductive, or urinary systems; as well as with problems or weakness in the muscles, nerves, and connective tissues of the pelvis.
The fact is, there are countless conditions that result in acute or chronic pelvic pain. Possible causes of pelvic pain in women include:
- Ovulation (Mittelschmerz)
- Menstrual cramps
- Ovarian cysts
- Uterine fibroids
- Ectopic pregnancy
- PID (Pelvic inflammatory disease)
- Uterine cancer
- Cervical cancer
Other possible causes of pelvic pain, in both men and women alike, include:
- Chronic constipation
- Bladder disorders
- Sexually transmitted diseases
- Kidney Issues, such as infections or kidney stones
- Intestinal disorders
- Nerve conditions
- Pelvic floor dysfunction
- Broken pelvis
- Psychogenic pain (Psychalgia)
- Crohn’s disease
- Intestinal obstruction
- Painful bladder syndrome
- a history of physical or sexual abuse
- Ulcerative colitis
- UTI (Urinary tract infection)
When to see a doctor
Pelvic pain can be the result of so many different conditions; some of which are serious, and some of which are merely painful, but harmless. However, the majority of these conditions do require medical attention. If the pelvic pain can be directly connected to ovulation or menstrual cramps, no further attention is needed. However, if the pain is constant and intense, medical attention should be the next step.
Immediate medical attention is also needed if pelvic pain develops suddenly and at intense levels of pain. For safety, and because pelvic pain can be an indication of very serious conditions; a good rule of thumb is to have the pain medically evaluated if it is new, if it disrupts everyday life, or if it persists or gets worse over time.
What symptoms need immediate medical attention?
- Increased and worsening menstrual cramps
- Inappropriate vaginal bleeding or spotting
- Unusual discharge
- Painful, difficult, severely increased, or severely decreased urination
- Chronic constipation or diarrhea
- Severe and disruptive bloating or gas
- Bloody stools
- Painful sexual intercourse
- Sudden and persistent fever or chills
- Pain that radiates to the hips, back, groin, or buttocks
Treatment & Therapy
The treatment for pelvic pain is completely dependent on the initial cause, the intensity of pain, the length of time the pain has persisted, and the frequency of pain. The proper treatment could be anything from therapy to surgery, and any conventional treatment or procedure in between. A primary care provider can evaluate the pelvic pain, form a diagnosis, and offer further information on all possible forms of treatment.
How will the doctor find a diagnosis and treatment plan?
In order to properly determine the direct cause of the pelvic pain, a doctor will ask a series of questions, related to current symptoms, medical history, and family history. Afterwards, a physical exam will be performed, as well as any necessary medical tests. Possible medical exams and tests include:
- Blood and urine culture tests
- Pregnancy tests for women
- Culture tests to test for sexually transmitted diseases
- X-rays and/or ultrasound scans
- CT Scans
- Bone density screening tests
- Diagnostic laparoscopy: a procedure that allows the technician to directly see the pelvic structures
- Hysteroscopy: a procedure that helps to examine the uterus
- Stool samples to check for signs of blood
- Endoscopy: a procedure in which a lighted tube is inserted to view the inside of the rectum and colon.
After all of the needed tests and procedures are performed, a proper treatment method can be analyzed. The following are common treatment methods for pelvic pain.
Another treatment method, commonly used for minor pelvic pain, is heat. Placing a heating pad, hot water bottle, or a warm compress against the abdominal and lower regions can do a lot in the way of pain therapy. It also helps to soak in a hot bath with Epsom salts.
Many times, minor pelvic pain can be eased through common relaxation methods. Take up forms of relaxation therapy: such as meditation, Yoga, breathing exercises, and progressive muscle relaxation to keep pelvic pain at bay.
Regular Exercise and a Healthy Diet:
It has been widely accepted that regular exercise and a healthy diet and lifestyle can attack common pains and aches, such as those of pelvic pain.
There are many different prescription medications that can be administered for the conditions of pelvic pain. These medications may include antibiotics, pain relievers, muscle relaxers, and antidepressants. Each medication is directly related to each condition, so there are no one size fits all medications.
For conditions such as endometriosis and menstruation complications, hormonal treatments have been known to be an effective remedy.
If the source of pelvic pain turns out to be physical or sexual abuse, or other mental or emotional issues; talk therapy will be considered the best solution.
Medicines and therapy are wonderful options for acute pelvic pain. However, these methods will not work to cure the underlying conditions that cause chronic and serious pelvic pains. They will only work to alleviate pain, other symptoms, and ensure the pain does not go from acute to chronic. Because of this, surgery is often the most likely treatment for specific chronic conditions. Such chronic conditions include, but are not limited to, uterine fibroid and endometriosis.
As an absolute last resort, a hysterectomy, the removal of the uterus and female organs, is used as an end to the pelvic pain and the underlying conditions. Again, this is only a last resort; it will only be recommended if there are no other options for treatment and cure.
Prevention & Prophylaxis
Early Diagnosis and Treatment
This measure may not be a form of prevention for the overall issue, per se, however, it does prevent the issue from becoming chronic. The earlier pelvic pain is diagnosed and treated, the better chances are of a full treatment, cure, and recovery.
A few very common causes of pelvic pain are pelvic inflammatory disease and sexually transmitted diseases. The risk for both of these problems can be profoundly reduced by practicing safe sex. This includes the proper and use of condoms with every sexual relation.
When it comes to acute or chronic pelvic pain, finding the right treatment can take a lot of time and patience. The first step is always to seek medical evaluation and attention. Combining medical treatments, preventative measures, and healthy lifestyle practices is likely the best course of action.