Pelvic pain

Introduction

Pelvic pain is lower abdominal pain felt below the level of the umbilicus. It may arise suddenly or could be mild and lasting for weeks and months.  The pain may arise from female reproductive organs or occasionally from bowels or bladder. Sometimes the cause of pelvic pain cannot be identified despite investigations.

Acute pelvic pain

Pain that arises suddenly may be caused by ovarian cysts, pelvic infection, appendicitis, bladder infection and bowel spasm. Acute pain during early pregnancy may be caused by threatened or actual miscarriage  or an ectopic pregnancy.

Chronic pelvic pain

Pain that is persistent or intermittently comes and goes, is called chronic pelvic pain, and may be caused by endometriosis, adenomyosis, chronic pelvic inflammation, irritable bowel syndrome and interstitial cystitis.

Treatment

Both acute and chronic pelvic pain need to be checked out by investigations so that the cause may be treated.  The first line would be an ultrasound of the pelvic organs. Sometimes, a surgical procedure, laparoscopy, may become necessary to find and treat the cause of pain. However, in up to a quarter of cases, no structural cause can be found, in which case treatment is by varying combination of pain killers.