Robert Wood Johnson University Hospital
 

Pelvic Pain

Pelvic Pain

What is pelvic pain?

Pelvic pain is a common complaint among women. Its nature and intensity may fluctuate, and its cause is often obscure. In some cases, no disease is evident. Pelvic pain can be categorized as either acute, meaning the pain is sudden and severe, or chronic, meaning the pain either comes and goes or is constant, lasting over a period of months or longer. According to the American College of Obstetricians and Gynecologists, pelvic pain lasting longer than 6 months and showing no improvement with treatment is known as chronic pelvic pain. Pelvic pain may originate in genital or extragenital organs in and around the pelvis, or it may be psychological, which can make pain feel worse or actually cause a sensation of pain, when no physical problem is present.

What causes pelvic pain?

Pelvic pain may have multiple causes, including:

Some of the more common sources of acute pelvic pain, or pain that occurs very suddenly, may include:

Some of the conditions that can lead to chronic pelvic pain may include:

This long-term and often unrelenting pain may cause a woman's defenses to break down, resulting in emotional and behavioral changes. This occurrence is often termed "chronic pelvic pain syndrome."

What are the different types of pelvic pain?

The following are examples of the different types of pelvic pain most commonly described by women, and their possible cause or origin. Always consult your health care provider for a diagnosis.

Type of Pain Possible Cause
Localized pain May be due to an inflammation
Colicky pain May be caused by spasm in a soft organ, such as the intestine, ureter, or appendix
Sudden onset of pain May be caused by a temporary deficiency of blood supply due to an obstruction in the circulation of blood
Slowly-developing pain May be due to inflammation of the appendix or an intestinal obstruction
Pain involving the entire abdomen May suggest an accumulation of blood, pus, or intestinal contents
Pain aggravated by movement or during examination May be a result of irritation in the lining of the abdominal cavity

How is pelvic pain diagnosed?

Diagnostic procedures and tests will be performed in order to determine the cause of the pelvic pain. In addition, your health care provider may ask you questions regarding the pain such as:

Additional information about the timing of the pain and the presence of other symptoms related to activities such as eating, sleeping, sexual activity, and movement can also help your health care provider in determining a diagnosis.

How is pelvic pain diagnosed?

In addition to a complete medical history and physical and pelvic examination, diagnostic procedures for pelvic pain may include:

What is the treatment for pelvic pain?

Specific treatment for pelvic pain will be determined by your health care provider based on:

Treatment may include:

If a physical cause cannot be found, pelvic pain may be diagnosed as a psychological defense or coping mechanism for some type of trauma. In some cases, psychotherapy is recommended. In other cases, health care providers may recommend a multi-disciplinary treatment utilizing a number of different approaches, including nutritional modifications, environmental changes, physical therapy, and pain management.

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