By Medicover Hospitals / 9 Feb 2021
Pain or discomfort, ranging from a sharp jerk to a dull ache in the lower abdomen and pelvis. Pelvic pain can have causes that are not because of an underlying disease. Examples include constipation, pregnancy, full bladder, sexual pain, menstruation, or trauma.
- What is Pelvic Pain?
- When to visit a Doctor?
- Home remedies
What is Pelvic Pain?
- Pelvic pain mainly occurs in the area of the lower abdomen. The pain can be constant or come and go. It can be a sharp, stabbing pain in a specific place or a dull ache that spreads. If the pain is severe, it could interfere with your daily activities.
- If you are a woman, you may experience pain during your period. It can also happen when you have sex. Pelvic pain can be a sign of a problem with an organ in your pelvic region, such as the uterus, ovaries, fallopian tubes, cervix, or vagina. If you are male, the cause could be a prostate problem. In both men and women, it can be a symptom of infection or a problem with the urinary tract, lower intestines, rectum, muscles, or bones. Some women have more than one cause of pelvic pain simultaneously.
The most common causes of pelvic pain in men:
Urinary tract infection (UTI):
A urinary tract infection is a bacterial infection somewhere along the urinary tract that includes the urethra, bladder, ureters, and kidneys. UTIs are a common complaint, and a more common symptom is pain in the lower abdomen or pelvis.
Other symptoms include:
- A burning sensation when urinating
- Need to urinate frequently
- Changes in the color or odor of urine
- Fever or chills
- Pain in other areas, like sides or lower back
Sexually transmitted infection (STI):
- Some STIs, like gonorrhea and chlamydia, also cause pelvic pain. The Centers for Disease Control and Prevention (CDC) estimates that 2.86 million chlamydia infections occur in the United States each year.
- Symptoms include:
- Pain in the pelvis
- Inflammation of the urethra
- Discharge from the penis
- Chlamydia can also infect the rectum or anus, possibly causing pain there as well.
- A condition called lymphogranuloma venereal can result from different versions of the bacteria that cause chlamydia. This can lead to pelvic pain that is difficult to treat.
- The CDC notes that lymphogranuloma venereum can cause outbreaks of proctitis, or inflammation of the anus and rectum, in men who have sex with men.
- The infection can cause symptoms such as pain and discharge from the penis. If it affects the rectum, it can cause a discharge from the anus or painful stools.
There are a few types of prostatitis:
Acute bacterial prostatitis:
- Prostatitis is an inflammation of the prostate, a tiny gland in the male reproductive system. The prostate produces fluid, which enters the semen.
- This condition results from a bacterial infection of the prostate. Bacteria can reach the gland through the urethra, and as they spread, they can cause pain in the pelvis, groin, or lower back.
- Acute bacterial prostatitis can also cause discomfort in the penis or testicles. Pain may accompany other symptoms, including:
- A burning sensation during urination
- Nausea and vomiting
- Difficulty urinating
- Frequent urination
- Urinary blockage or inability to urinate
- A weak or broken urine stream
- Waking up frequently at night to urinate
- Painful ejaculation
Chronic bacterial prostatitis:
- A bacterial infection of the prostate can be serious and anyone with these symptoms should see a doctor immediately. A urologist can treat a bacterial infection with antibiotics.
Long-lasting inflammation of the prostate can result from non-bacterial prostatitis, a type of chronic pelvic pain syndrome.Doctors are not sure of the exact cause of this condition. It's important to understand that the inflammation has nothing to do with a bacterial infection, so it won't respond well to antibiotics.
Asymptomatic inflammatory prostatitis:
Prostatitis can cause virtually no symptoms. Blood tests may show a higher number of white blood cells, and doctors will want to rule out prostate cancer before making a diagnosis.
- Chronic bacterial prostatitis is a common infection in the prostate. Symptoms are like those of acute bacterial prostatitis, although they may be less severe.
- A urologist will usually treat it with a low dose of antibiotics, or a combination of antibiotics, over a longer period.
- If the problem is causing difficulty passing urine, the urologist may prescribe medications called alpha-blockers to help relax the bladder and surrounding muscles so the body can release urine.
- Sudden lower abdominal pain can indicate a hernia.
- A hernia develops when a piece of tissue or intestine pushes through a weak spot in the muscles. It often forms a small painful swelling in the area.
- The pain may get worse when the person puts a strain on the muscles, such as laughing, coughing, or lifting.
Irritable Bowel Syndrome (IBS):
IBS typically causes symptoms along the intestinal tract, such as:
These symptoms usually disappear temporarily after stool.
- Painful cramps
- Mucus in stool
The appendix is a small organ on the right side of the body, and inflammation of the appendix can cause pelvic pain.
Other symptoms include:
If sharp pain in the lower right abdomen accompanies any of the above symptoms, seek medical attention immediately. Surgery may be necessary.
- Loss of appetite
- Nausea and vomiting
- Swelling of the lower abdomen
- Urinary stones are formed when salts or minerals, such as calcium, build up in the urine and the body has difficulty getting rid of them. These minerals can clump together and crystallize in urinary stones.
- Stones tend to cause symptoms only when the body tries to pass them, and pain in the pelvis or lower back is common. Other changes include difficulty passing urine and blood in the urine.
- Doctors may prescribe pain relievers to help pass the stones, and some medications can break up the stones. Larger stones require surgery in some cases.
- Cystitis is inflammation of the bladder, usually resulting from infection.
- It causes pain in the pelvis, accompanied by symptoms such as:
A doctor will usually use a short course of antibiotics to treat a bladder infection.
- Difficulty urinating
- Poor urine output
- Having to urinate frequently
- Burning pain when urinating
- Blood in urine
- Changes in the appearance or odor of urine
Urethral stricture occurs when the urethra shrinks or blockages, making it difficult for the urine to flow. In addition to lower abdominal pain, symptoms include:
Treatment involves surgery, and these vary.
- Pain when urinating
- Difficulty urinating
- Urine leak
- Blood or urine appearing in semen
- Loss of bladder control
Benign Prostatic Hyperplasia (BPH):
BPH occurs when the prostate gets bigger due to something other than cancer.As the prostate enlarges, it puts pressure on the urethra. This can cause difficulty passing urine and pain in the pelvis. Eventually, the muscles of the bladder may weaken from the tension, which makes symptoms worse.
The most common causes of pelvic pain in Women:
Menstrual Pain and Cramps:
- Menstrual pain and cramps are a common cause of pelvic pain in women.
- More than half of women who have their period will experience pain for at least 1 to 2 days in each cycle.
- Period cramps usually occur immediately before a woman starts her period because the uterus contracts and loses its lining. The pain may look like a muscle spasm or a stinging pain.
- Using a warm heating pad can ease the sensation. Over-the-counter medications, such as ibuprofen (Advil) and naproxen (Aleve), can also help relieve pain.
- In case of severe pain due to menstruation, doctors may recommend other medications.
- When a woman ovulates, the ovaries release an egg and other fluids. The egg will then travel through the fallopian tube and into the uterus. Fluid released by the ovary can travel to the pelvic area, sometimes causing pelvic irritation and pain.
- The discomfort can last for minutes or hours and change sides of the body, depending on which ovary released the egg. The pain is temporary and does not require any specific treatment.
- It is also possible that a woman suffers from continued inflammation of the bladder with no known cause. The medical term for this is interstitial cystitis, and doctors currently don't know why this happens.
- Interstitial cystitis can cause pelvic pain and symptoms such as painful urination, the need to urinate frequently, and pain during sex. Treatment often involves managing the symptoms as well as possible.
- Cystitis refers to inflammation of the bladder due to a bacterial infection. This happens because bacteria from the vagina, rectum, or skin can enter the urethra and travel to the bladder.
- A urinary tract infection (UTI) can occur anywhere in the system, while cystitis only occurs in the bladder.
- Both conditions are common in women. Sometimes these infections will go away on their own, but a short course of antibiotics will usually treat cystitis and other UTIs.
Sexually Transmitted Infections:
- Pelvic pain may indicate the presence of a sexually transmitted infection (STI) such as gonorrhea or chlamydia. STIs occur in sexually active people.
- In addition to pelvic pain, other symptoms of STIs can include painful urination, bleeding between periods, and changes in vaginal discharge.
- Anyone who experiences these changes should see their doctor who will be able to diagnose an STI and prescribe treatment, usually including antibiotics. It is also essential to let sexual partners know about the infection to prevent it from spreading.
Pelvic Inflammatory Disease:
- Pelvic inflammatory disease (PID) is an infection of the uterus that can damage surrounding tissue. PID can occur if bacteria from the vagina or cervix enter the uterus and settle.
- It is usually a complication of an STI such as gonorrhea or chlamydia. In addition to pelvic pain, women may experience other symptoms, including abnormal vaginal discharge and bleeding.
- IRS increases the risk of infertility in women. The CDC notes that 1 in 8 women who have had PID also have trouble getting pregnant.
- Treatment usually involves taking antibiotics to treat the bacterial infection. However, they cannot treat scars, which is why early treatment is crucial.
- Endometriosis occurs when the endometrium, or tissue that lines the inside of the uterus, grows outside the uterus.
- Endometriosis can be a source of chronic and lasting pelvic pain in some women. When a person's period begins, this tissue outside the uterus responds to hormonal changes, which can cause bleeding and inflammation in the pelvis.
- Some people may experience mild to severe pain. Endometriosis can make it difficult for some women to get pregnant. Doctors may recommend a variety of treatments, depending on the severity of the symptoms.
Irritable bowel syndrome (IBS):
- Irritable Bowel Syndrome (IBS) is an intestinal disorder that causes pain and symptoms, including constipation, diarrhea, and bloating.
- Symptoms of IBS tend to flare up and go away over time, especially after a bowel movement. There is no cure for IBS, so treatment focuses on managing symptoms through changes in diet, stress levels, and medications.
- Appendicitis is inflammation of the appendix, which is a small organ located in the lower right abdomen. This condition is caused by infection, and although it is common, it can be serious.
- Anyone experiencing sharp pain in the lower right abdomen, along with other symptoms such as vomiting and fever, should see a doctor immediately, as this can be a sign of appendicitis.
- Stones in the urinary tract are made up of salts and minerals, such as calcium, which the body has difficulty in passing through urine.
- These minerals can build up and form crystals in the bladder or kidneys which often cause pain in the pelvis or lower back. Stones can also cause urine to change color, often turning it pink or reddish with blood.
- Some stones do not require treatment, but passing them can be painful. At other times, a doctor may recommend medicine to break up the stones or surgery to remove them.
- An ectopic pregnancy occurs when an embryo implants anywhere outside the uterus and begins to develop.
- A woman may experience very sharp pain and cramp in her pelvis, which is usually concentrated on one side. Other symptoms include nausea, vaginal bleeding, and dizziness.
- Anyone who suspects an ectopic pregnancy should see a doctor immediately, as it is a potentially fatal condition.
- An adhesion is scar tissue that occurs inside the body and connects two issues that should not be connected. This can lead to pain, as the body has a hard time adjusting to the grip.
- Scar tissue can form due to an old infection, endometriosis, or other problems in the area. Pelvic adhesions can lead to chronic pelvic pain in some women, and they can cause other symptoms, depending on where the scar tissue appears.
- A doctor may recommend minimally invasive surgeries to help reduce adhesions and relieve symptoms.
- Ovarian cysts occur when the ovaries fail to release an egg. The follicle containing the egg may not fully open to release the egg, or it may be clogged with fluid.
- When this happens, a growth called cyst forms in the area, which can cause bloating, pressure, or pelvic pain on the side of the body with the cyst.
- In many cases, ovarian cysts go away on their own. In some cases, a cyst can bleed or burst, which can cause severe, severe pain in the pelvis and may require medical treatment.
- Doctors can identify ovarian cysts using ultrasound, and they can recommend treatments ranging from watchful waiting to surgery.
- Fibroids are pieces of muscle and fibrous tissue in the uterus. Although they are not cancerous and do not tend to cause symptoms, these growths can be a source of pain. They can cause discomfort in the pelvis or lower back or pain during sex.
- Fibroids can also cause excessive bleeding or cramping during menstruation.
- Some fibroids do not require treatment. If a woman finds her symptoms difficult to manage, doctors may recommend one of the many treatments, including medications, non-invasive procedures, or surgery.
- In rare cases, malignant growth of the reproductive system, urinary tract, or gastrointestinal system can be the cause of pelvic pain. The tumor can also cause other symptoms, depending on where it appears.
- Doctors will need to do a thorough evaluation, often using blood tests and imaging, to identify a tumor. Once they diagnose the problem, they will recommend possible treatments.
Determining what is causing your chronic pelvic pain often involves a process of elimination, as many disorders can cause pelvic pain.
In addition to a detailed interview about your pain, personal medical history, and family history, your doctor may ask you to keep a diary of your pain and other symptoms.
Tests or exams your doctor might suggest include:
Pelvic exam: This may reveal signs of infection, abnormal growths, or tight pelvic floor muscles. Your doctor checks for areas of tenderness. Tell your doctor if you experience any discomfort during this test, especially if the pain is similar to the pain you felt.
Lab tests: During the pelvic exam, your doctor may ask labs to check for infections, such as chlamydia or gonorrhea. Your doctor may also order blood tests to check your blood count and a urinalysis to look for a urinary tract infection.
Ultrasound: This test uses high-frequency sound waves to produce precise images of the structures in your body. This procedure is especially useful for finding lumps or cysts in the ovaries, uterus, or fallopian tubes.
Other imaging tests: Your doctor may recommend abdominal x-rays, computed tomography (CT), or magnetic resonance imaging (MRI) to help find abnormal structures or growths.
Laparoscopy: During this surgery, your doctor makes a small incision in your abdomen and inserts a thin tube attached to a small camera (laparoscope). The laparoscope allows your doctor to view your pelvic organs and look for abnormaltissue or signs of infection: this procedure is especially useful for detecting endometriosis and chronic pelvic inflammatory disease.
Finding the underlying cause of chronic pelvic pain can be a long process, and sometimes a simple explanation may never be found.
Treatment for pelvic pain varies depending on the cause, the intensity of the pain, and how often the pain occurs. Sometimes pelvic pain is treated with medication, including antibiotics. If the pain results from a problem with any of the pelvic organs, treatment may involve surgery or other procedures. Physiotherapy can sometimes be helpful. Plus, since living with chronic pelvic pain can be stressful and overwhelming, studies have shown the benefit of working with a trained counselor, psychologist, or psychiatrist most of the time. A doctor can provide more information about the different treatments for pelvic pain.
When to visit a Doctor?
Temporary, mild pelvic pain is probably nothing to worry about. If the pain is severe or persists for more than a week, make an appointment with your doctor.
You should see the physician if you experience:
- Blood in urine
- Foul-smelling urine
- Difficulty urinating
- Inability to have a bowel movement
- Bleeding between periods
Pelvic pain often responds to over-the-counter pain relievers, but be sure to consult your doctor before taking any type of medication during pregnancy.
In some cases, rest can help. In others, gentle movements and light exercise will be more beneficial. Try these tips:
- Place a hot water bottle on your abdomen to see if it helps relieve the cramps or take a warm bath.
- Elevate your legs. This can help relieve pelvic pain and pain, which affects the lower back or thighs.
- Try yoga, prenatal yoga, and meditation, which can also be helpful for pain management.
- Take herbs, such as willow bark, which can help reduce pain. Obtain your doctor's approval before using it during pregnancy.
Frequently Asked Questions:
In women, pelvic pain can be a sign of menstrual cramps, ovulation, or a gastrointestinal problem such as food intolerance. It can also develop because of more severe problems. Sometimes pelvic pain is an indicator of an infection or a problem with the reproductive system or other organs in the area.
The pelvis is the bottom part of the torso. It is located between the abdomen and the legs. This area supports the intestines and also contains the bladder and reproductive organs. There are structural differences between the female and male pelvis.
Pelvic pressure in the pelvis and rectal area looks like cramps (similar to menstrual cramps) and discomfort in the groin and is often accompanied by lumbar back pain. It is also more likely to occur in the second and subsequent pregnancies.
The pelvic organs include the bladder, uterus and cervix, vagina, and rectum, which are part of the intestine.
Irritable Bowel Syndrome (IBS), is one of the most common causes of chronic pelvic pain symptoms in both men and women. IBS can cause cramps in the lower abdomen Problems with bowel function, including diarrhea, constipation, and bloating.
Predisposing women to chronic pelvic pain - https://www.bmj.com/content/332/7544/749?ehom
Reduction of back and posterior pelvic pain in pregnancy - https://europepmc.org/article/med/8009346
Chronic Pelvic Pain- https://www.sciencedirect.com/science/article/abs/pii/S0029784402027230