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Pelvic Pain

Published on Jan 31, 2019 and last reviewed on Jul 15, 2022   -  7 min read

Abstract

The pain felt below the umbilicus and above the thigh is known as pelvic pain. It can be caused by a number of things, which ranges from being harmless to a medical emergency

Pelvic Pain

Pelvic Pain Overview

The pain felt below the umbilicus and above the thigh is known as pelvic pain. It can be caused by a number of things, which ranges from being harmless to a medical emergency. There are a lot of organs in the pelvic region like bowel, bladder, ovaries, uterus, appendix, etc., so the pain can be due to problems is any of these organs. When you have pelvic pain, it is crucial to differentiate when it is normal and when to seek help.

The pain can begin suddenly or be cyclic or dull or sharp or be accompanied with itching and burning around the genitals and thighs. In women, it feels different from the usual menstrual cramps. The pain can worsen with movement, on lifting things, straining, and stress. Chronic pelvic pain that is pain present on most days for six months should not be ignored, and finding the cause is essential.

What are the causes of Pelvic Pain?

The possible causes of pelvic pain in both men and women are:

  • Appendicitis - The inflammation of the appendix is called appendicitis. The pain starts near the belly button and moves toward the right side of the lower abdomen. It is a medical emergency as the inflamed appendix can rupture and cause infection.

  • Irritable bowel syndrome (IBS) - A group of diseases affecting the large intestine is called IBS. Here, the patient has abdominal cramps, constipation or diarrhea, bloating, gas, and mucus in stools. The pain usually subsides after a bowel movement.

  • Sexually transmitted diseases (STD) - STDs like gonorrhea and chlamydia cause dull pain in the abdomen. The other symptoms include discharge from the vagina and penis, pain during sex, pain on urination, and pain or bleeding from the rectum.

  • Bladder disorder or Urinary tract infection (UTI) - Bacterial infection of the urinary tract, which includes the urethra, bladder, ureters, and kidneys is called UTI. It usually causes pain in the middle of the pelvis and around the pubic bone. The other symptoms are persistent urge to urinate, pain or burning on urination, bloody or cloudy urine, and fever.

  • Kidney stones or kidney infection - A kidney stone and infection can cause pain that starts at the side and back and radiates to the lower belly and groin. Blood in urine, frequent urge to urinate, burning on peeing, nausea, vomiting, and fever are other associated symptoms.

  • Interstitial cystitis (IC) - Also called painful bladder syndrome, which is a condition that causes bladder pressure and chronic pelvic pain. The pain in women is felt between the anus and vagina. In men, it is felt between the scrotum and anus.

  • Scar tissue formation after any surgery - Scar tissue form after any open surgery of the pelvic region like c-section. This scar tissue grows between organs like bladder, bowel, ureter, and ovaries and causes pelvic pain.

  • Hernia - A hernia is caused when a tissue or organ pushes through a weak spot in your abdomen. The pain increases with coughing, laughing, and bending. In men, it also causes swelling around the testicles.

  • Fractured pelvic bone - The pelvic bone can break during an accident. It causes pain in the hip, groin, and lower back, and the pain increases on walking and moving the legs.

  • Nonrelaxing pelvic floor dysfunction - Here, the pelvic floor muscles are too tight. The spasm in the levator ani muscle causes constant dull pain in the rectum.

  • Iliac crest pain syndrome - It occurs when the iliolumbar ligament, which is a ligament that connects the vertebrae to the pelvic bone, tears. It causes pain in the lower back that can spread to the hip and groin.

  • Psychogenic pain - Pain that is caused by psychological factors like depression and anxiety is called psychogenic pain.

The possible causes of pelvic pain in women alone are:

  • Ectopic pregnancy - Ectopic pregnancy is when a fertilized egg gets attached anywhere outside the uterus. The pain experienced here is sharp, stabbing, and one-sided.

  • Miscarriage - Loss of a baby before the 20th week of the pregnancy is called a miscarriage. Severe cramps and pain in the stomach with spotting or bleeding are the signs of a miscarriage.

  • Mittelschmerz (painful ovulation) - Pain felt by a woman during ovulation is called mittelschmerz. The pain can be sharp or dull, one-sided, and can last for a few minutes to hours.

  • Premenstrual syndrome (PMS) and menstrual cramps - It is the abdominal pain and discomfort felt before and during the menstrual period. The other symptoms that you might have are sore breasts, bloating, mood changes, diarrhea, nausea, etc.

  • Pelvic inflammatory disease (PID) - Bacterial infection of the female reproductive organs is called PID. The pain is in the center of the lower abdomen, and it can be tender to touch.

  • Pelvic congestion syndrome(PCS) - It is the condition that results from the formation of varicose veins in the pelvic region. The pain is dull, and it increases on standing up, in evenings, before menstruation, and during sex.

  • Ovarian torsion - When the ovary and fallopian tubes entangle with the surrounding tissue it is called ovarian torsion. It causes severe and sudden pain in the lower abdomen.

  • Ovarian cyst rupture - Cysts, which are fluid-filled sacs, present in the ovaries twist or rupture causing pain in the lower abdomen. The pain can be sharp or dull.

  • Uterine fibroids - Growths in the wall of the uterus is called uterine fibroids. They are commonly seen in reproductive age women. Larger fibroids can cause pressure and pain in the pelvis.

  • Endometriosis - Growth of the uterine tissue outside the uterus is called endometriosis. It causes severe pain before and during periods, heavy bleeding, fatigue, and nausea.

  • Pelvic organ prolapse - The muscles that support the bladder, uterus, and rectum become weak with age and childbirth. This causes these organs to fall into the vagina. It produces a feeling of pressure and heaviness in the pelvis.

  • Vulvodynia - It is a pain or discomfort felt around the vulva (opening of the vagina). It causes pain, burning, and irritation on sitting or during sex.

  • Cervical or ovarian or uterine cancer - Cancer of the reproductive organs can also cause pelvic pain.

The possible causes of pelvic pain in men alone are:

  • Bacterial prostatitis - Inflammation of the prostate gland due to bacterial infection is called bacterial prostatitis. Apart from pelvic pain, frequent urination, fever, chills, nausea, and fatigue are also its symptoms.

  • Chronic pelvic pain syndrome - Pelvic pain that lasts for more than 3 months with no obvious cause is called chronic pelvic pain syndrome. The patient usually has pain in the penis, testicles, lower abdomen, and near the perineum.

  • Urethral stricture - Narrowing or blockage of the urethra is called urethral stricture. This blockage can be caused due to swelling, injury, or infection of the urethra. It causes pain during urination.

  • Benign prostatic hyperplasia (BPH) - It is the enlargement of the prostate gland. As the size of the prostate gland grows, it puts pressure on the urethra and causes pain.

  • Post-vasectomy pain syndrome - Vasectomy is the surgery that cuts the vas deferens so the sperm cannot get into the semen. Some people experience pain in the testicles for up to 3 months after this surgery.

Some symptoms occur along with pelvic pain, they are -

  1. Menstrual cramps and pain.

  2. Vaginal discharge.

  3. Painful urination or burning on peeing.

  4. Constipation or diarrhea.

  5. Gas.

  6. Blood in stools.

  7. Pain during sex.

  8. Fever.

  9. Chills.

  10. Pain in the hip and groin.

Diagnosis of Pelvic Pain:

When you visit the doctor for pelvic pain, the doctor will ask you questions like when the pain started, what are the factors triggering it, what gives you relief, how long have you had this pain, is the pain dull or sharp or aching, etc. The doctor might also ask about your sex life and family history, to rule out sexually transmitted infection and hereditary cancers.

Then the doctor will perform a pelvic examination, where he or she checks any abnormalities like masses or tenderness in the pelvic region. After this, depending on the history and physical examination, the doctor might ask you to perform all or a few of the following tests.

  • Blood test.
  • Urine test.
  • Vaginal and semen culture.
  • X-rays.
  • Diagnostic laparoscopy.
  • Hysteroscopy.
  • Stool test.
  • Colonoscopy or sigmoidoscopy.
  • Ultrasound.
  • CT scan.

What are the Treatments for Pelvic Pain?

The treatment for pelvic pain depends on the cause, the severity of pain, and the frequency of pain. Depending on the cause, it can be treated with medicines like antibiotics and painkillers, surgery, or other therapeutic measures. For example, antibiotics are given for pelvic inflammatory disease and surgery is indicated in cases of ectopic pregnancy, cervical or uterine cancer, appendicitis, and ovarian torsion. In some chronic cases, physiotherapy and psychological counseling are also needed.

When to Consult a Doctor?

Mild and temporary pain in the pelvic region is usually nothing to worry about, but if the pain gets severe and becomes continuous, then it is best to consult your doctor. You should also seek immediate medical help if pelvic pain is accompanied with blood in urine or stool, difficulty urinating, fever, chills, constipation or diarrhea, and vaginal spotting.

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Frequently Asked Questions


1.

What Are The Characteristics Of Pelvic Pain?

Pelvic pain is usually felt in the lower abdomen. The pain can be due to several problems that relate to the lower abdominal and pelvic organs. It can be acute or chronic in onset. The pain is usually felt in the lower back region, and it radiates to the inner thighs in most cases. The pain might be sharp or dull, depending on the cause and organ involved.

2.

Where Is the Pelvic Area located?

The pelvic area is the area at the hips below the umbilicus. It is usually protected by the help of the pelvic girdle. The pelvic girdle comprises of several muscles and bones. All the male and female reproductive systems, along with the excretory organs, are seen in the pelvic area.

3.

When Should a Patient Be Concerned About Their Pelvic Pain?

A person must be worried about his or her pelvic pain during the following situations.
- When the pain is sudden in onset with severe nature.
- When the pain is progressive for a long period of time.
- When the pain affects the routine activities of the individual.
- When the pain occurs along with changes in the menstrual cycle of women.
- When pain occurs during the event of sexual intercourse.

4.

What Organs Does The Pelvic Region Consist Of?

The organs present in the pelvic regions of the male are:
- Rectum.
- Anus.
- Urinary bladder.
- Urethra.
- Penis.
- Scrotum.
- Prostate.
The organs present in the pelvic regions of the female are:
- Rectum.
- Anus.
- Urinary bladder and urethra.
- Uterus and vagina.
- Ovaries.

5.

How Many Types Of Pelvis Are There And What Are They?

The pelvis is broadly classified into four distinct types. They are
- Gynecoid.
- Android.
- Anthropoid.
- Platypelloid.
Among these, the most common type of pelvis seen in women is the gynecoid pelvis. In males, the most common type of pelvis is the android type.

6.

What Are The Various Causes Of Lower Pelvic Pain and Pressure?

In females, the most common and normal cause of lower pelvic pain and pressure are pregnancy and menstruation. The other abnormal causes are:
- Irritable bowel syndrome.
- Urinary tract infection.
- Painful bladder syndrome.
- Endometriosis.
- Polycystic ovarian disease (PCOD).
- Cancers of the uterus, ovaries, cervix, vaginal canal, urethra, etc.
- Sexually transmitted infections.
In males, the causes are:
- Urethritis.
- Prostatitis.
- Irritable bowel syndrome.
- Cancers of the scrotum, penis, bladder, prostate, rectum, etc.
- Sexually transmitted diseases.

7.

How Long Will A Patient Experience Pelvic Pain?

Pelvic pain has been classified into two categories based on the onset. It is acute and chronic pain. Acute pain is usually sudden in onset and causes severe pain for a short duration of time. The time ranges between hours to days only. On the other hand, chronic pain slows in onset and the pain progresses for several months to years. Acute pain is seen in inflammatory and infectious diseases of the pelvis, such as urethritis. Chronic pain is seen in patients suffering from cancers of the pelvis.

8.

Can Stress and Anxiety Lead To Pelvic pain?

Yes, stress and anxiety can lead to pelvic pain. This is termed medically as the pelvic stress reflux. When a person undergoes a stressful condition or an anxiety attack, the pelvic area also causes pain as a response. The exact mechanism has not been identified yet. However, stress hormones tend to play a vital role in this condition. Along with pelvic pain, patients might also experience loose bowel movements and incontinence.

9.

Does Exercise Help In Relieving Pelvic Pain?

Yes, exercise helps in relieving pelvic pain. The reason behind this is that exercises boost circulation in the body. Also, exercise leads to the secretion of hormones known as endorphins. Endorphins have been proven as natural pain killers by several studies. Yoga is also highly beneficial.

10.

What Are The Different Methods To Reduce Pelvic Tension?

Pelvic tension in patients can lead to the incidence of pelvic pain. It is mainly because of the stiffness produced by the bones and muscles of the pelvic ring. This tension can be relieved with the help of tension relief physiotherapy and yoga. It is important to do these therapies under the proper supervision of trained specialists to avoid consequences.

11.

Can Pelvic Pain Be Caused Due to Abnormalities In Muscles?

Yes, pelvic pain can be caused by abnormalities in the pelvic muscles. The pelvic region is normally composed of tightly linked muscles and ligaments. These muscles can cause pain when they undergo any trauma or spasms. The other pelvic muscle conditions that cause pain are levator ani syndrome, and prolapse of the pelvic muscular organs.

12.

Can Pelvic Pain Be Elicited by Cough?

Yes, pelvic pain can be elicited by cough. If a person is affected with an inguinal hernia, when he or she coughs, the abdominal organs push through the abdominal muscles. The exact site where the organs protrude through the wall is known as a weak spot. This causes pain in the pelvic area.

13.

Can Walking Cause Pelvic Pain?

In certain conditions, pelvic pain can be caused due to walking. They are:
- Sacro-iliac joint inflammation.
- Pubic symphysis dysfunction.
- Osteitis pubis.
- Inguinal hernia.
- Appendicitis.
- Diverticulitis.
- Pelvic congestion syndrome.
- Bone cancers.

14.

Why Do Pregnant Women Get Pelvic Pain While Sneezing?

Most of the pregnant women experience a sharp pain that radiates around their abdomen and pelvis when they sneeze. Though this pain is hard to bear, it is not very dangerous. As the uterus enlarges during pregnancy, the ligaments that attach it to the pelvis and nearby organs are stretched. This stretch is aggravated while sneezing and thus causes pain. This pain is called round ligament pain.

15.

What Causes Pelvic Pain During Urination?

Any infection or inflammation at the urinary bladder and urinary tract cause pelvic pain during urination. This is very common in females when compared to males. It can also be caused by renal stones or bladder stones.

16.

What Causes Pelvic Pain When Bladder Is Full?

Pelvic pain when the urinary bladder is full is caused by a condition known as interstitial cystitis. It is a chronic condition where the walls of the urinary bladder become irritated and inflamed. This leads to the pain and pressure of the bladder leading to pelvic pain.

17.

What Are the Remedies for Pelvic Pain During Pregnancy?

Pelvic pain is normal during the delivery of the baby. It is necessary to cause adequate pressure to push the baby from the uterus to the outside. However, the severity of pain can be managed by rest and pelvic physiotherapy if the pain occurs during the first or second trimester. If the pain continues, it might cause danger to the mother or fetus. Therefore, a proper medical consultation is always necessary.

18.

What Foods Relieve Pelvic Pain?

Foods that are rich in quercetin can relieve pelvic pain, such as:
- Broccoli.
- Cranberry juice.
- Red onions.
- Peppers.
- Apples.
- Grapes.

19.

How Can I Treat Pelvic Pain at Home?

The following are the different ways by which you can cure pelvic pain at home.
- Rest as much as possible.
- Drink water.
- Try yoga.
- Try over the counter pain relievers with proper doctor advice.
If the pain does not subside on the following measures, it is essential to reach for proper medical care.

20.

What Causes Pelvic Pain During Sex?

Pelvic pain during sex is caused by the following reasons.
- Sexually transmitted diseases.
- Infections of the vagina or penis.
- Vaginal dryness.
- Urinary tract infections.

Last reviewed at:
15 Jul 2022  -  7 min read

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