Pelvic pain is defined as discomfort in a woman’s lower abdomen, between her navel and her groin. It can be sharp or dull, constant or intermittent, or worsen with certain activities. For example, it may occur during menstruation. It also can occur only at certain times, such as before or after eating, while urinating, or during sex.
There are a variety of causes of pelvic pain, some of which may not be related to the reproductive organs but to the urinary tract or bowel. Causes of pain may also be related to more than one cause, and in rare instances, the cause is not found. Some more common causes include menstrual pain and cramping, ovulation, interstitial cystitis, UTIs, sexually transmitted infections, pelvic inflammatory disease, endometriosis, IBS, appendicitis, urinary stones, ectopic pregnancy, pelvic adhesions, ovarian cysts, uterine fibroids, or tumors.
Your health care provider will ask about your medical history. Your workup should also entail a general physical and pelvic exam. Various tests may be performed and/or referral to a specialist such as a gastroenterologist (a physician who focuses on digestive problems) or urogynecologist (a gynecologist specializing in urinary and related problems) may be made.
Some of the following imaging tests may be performed:
Pelvic exam: Your healthcare provider will perform this exam to check for any areas of tenderness or discomfort. This test can can reveal signs of infection, abnormal growths or tense pelvic floor muscles.
Lab tests: During the pelvic exam, your healthcare provider may order labs to check for infections, such as chlamydia or gonorrhea. In addition, your healthcare provider may also order bloodwork, a urinalysis, or a urine culture.
Ultrasound: This test uses high-frequency sound waves to produce 2-dimensional images of structures within your body. This procedure is especially useful for detecting masses or cysts in the ovaries, uterus or fallopian tubes.
Other imaging tests: Your doctor may recommend abdominal X-rays, computerized tomography (CT) scans or magnetic resonance imaging (MRI) to help detect abnormal structures or growths.
Laparoscopy: This is a surgical procedure in which a surgeon makes a small incision in your abdomen to allow for a small camera (laparoscope) to be inserted. The laparoscope allows your surgeon to view your pelvic organs and check for abnormal tissues or signs of infection. This procedure is especially useful in detecting endometriosis and chronic pelvic inflammatory disease.
The best method to treat pelvic pain is to address the underlying cause. Depending on what is causing the pain, methods such as medications, physical therapy, nutritional therapy, and surgery may be recommended.