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Sudden Stabbing Pain in Female Pelvic Area

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Pelvic pain can be due to various reasons and is quite a difficult and unbearable condition in women. Read the article for more information about it.

Written by

Dr. Asha. C

Medically reviewed by

Dr. Richa Agarwal

Published At October 31, 2022
Reviewed AtAugust 25, 2023

Introduction:

Women experience pelvic pain during various stages of life like during childbirth, menstrual cycles, and any medical conditions like kidney stones, endometriosis, etc. Pelvic pain can be an unbearable type of pain as the woman can experience sharp and shooting pain in the lower abdominal area. This type of pain may need medical attention. Pelvic pain may occur in all genders and can be due to infections, anomalies in internal organs, or pain from the pelvic bones. Treatment depends on the root cause of the pelvic pain.

What Is Pelvic Pain?

The pain in the pelvic area below the belly button and above the legs is known as pelvic pain, and it is often referred to as a dull ache, pain, or pressure located in the abdomen below the navel. If the pain is sudden and unexpected, it is called acute pelvic pain, and if the pain is present for the long term, it is called chronic pain. Pelvic pain can be a sign of problems with the reproductive organs like the uterus, ovaries, fallopian tubes, cervix, and vagina in a woman's pelvic area. It can also include other symptoms like lower back pain or vaginal bleeding.

What Are the Symptoms Associated With Pelvic Pain?

Many symptoms are related to pelvic pain. Some of these symptoms include the following:

  • Menstrual cramps.

  • Menstrual pain.

  • Vaginal bleeding or spotting.

  • Cloudy white discharge.

  • Painful urination.

  • Fever.

  • Bloating. (A swelling or feeling of fullness in the abdomen.)

  • Blood in stools.

What Are the Common Causes of Acute Pelvic Pain in Women?

The sudden and unexpected onset of pelvic pain is called acute pelvic pain. This may be due to the following conditions:

Ovarian Cysts:

Ovarian cysts are fluid-filled sacs or pockets that can develop on the surface of the ovaries or inside the ovaries. A follicular cyst occurs when the follicle does not break or release its egg but continues to grow. The fluid that accumulates inside the follicle after the follicles release the egg is called a corpus luteum cyst. Ovarian cysts are more common and can appear at any age.

The main symptom of ovarian cysts is sharp pains in the lower portion of the abdomen. Other symptoms include bloating, fullness or heaviness in the abdomen, nausea, vomiting, and pain during intercourse. The ovarian cyst can be prevented with regular pelvic examination and be altered with any changes in the monthly cycle. There can be pinching pain in the left ovary or the right ovary before the period.

Appendicitis:

Appendicitis is an inflammation of the small finger-shaped organ called the appendix that projects from the lower right side of the abdomen. If there is blockage or infection in the appendix's lining, the bacteria multiply rapidly, causing the appendix to become swollen, inflamed, and filled with pus. If not treated promptly, the appendix can rupture. Appendicitis develops between the ages of 15 to 30. The symptoms include a sudden sensation of stabbing in the lower right portion of the abdomen which is characterized as the right pelvic pain. Lower left pelvic pain cannot be of appendicitis as the appendix is not present there. It can be accompanied by nausea, vomiting, loss of appetite, abdominal bloating, diarrhea, and a low-grade fever. The treatment involves the surgical removal of an infected appendix. Stabbing pain above the belly button may mean something else and that is why an expert’s advice is needed to make the diagnosis.

Pelvic Inflammatory Disease:

Pelvic inflammatory disease is an infection of the female reproductive system that can affect the cervix, uterus, fallopian tubes, or ovaries. It often occurs when sexually transmitted bacteria move from the vagina to the uterus, fallopian tubes, or ovaries which are acquired during unprotected sex. The main symptom of PID is mild to severe pain in the lower region of the abdomen. Other symptoms of PID include upper abdominal pain, vaginal discharge, fever, fatigue, irregular bleeding, dull ache in the cervix area, or painful sex or urination. It can be prevented by safe sex. In the initial stage, antibiotic treatment will be helpful. It can cause life-threatening conditions like sepsis if left untreated.

Peritonitis:

Inflammation of the peritoneum (the thin layer of tissue on the abdomen's inner wall) is called peritonitis. It usually occurs due to a bacterial or fungal infection. There are two types of peritonitis.

  • Spontaneous Bacterial Peritonitis - It is caused due to complications of liver disease, such as cirrhosis.
  • Secondary Peritonitis - It is caused due to perforations in the abdomen or as a complication of other medical conditions.

Peritonitis symptoms include abdominal pain or tenderness, abdominal distention, constipation or diarrhea, fatigue, nausea, vomiting, low urine output, fever, and chills. The most common treatments for peritonitis are antibiotics and pain medications. In severe cases, surgery may be required to remove infected tissues.

Urinary Tract Infections:

Urinary tract infections (UTIs) are common infections that affect the urinary tract, including the kidney, urethra, bladder, and ureters. Bacteria commonly cause urinary tract infections, but sometimes fungi and viruses can also be the cause. If UTI affects the kidney, serious consequences can occur. The symptoms include stabbing, sharp or cramping pains in the lower region of the pelvis, a burning sensation while urinating, stabbing pain when peeing, random vaginal pain, persistent urge to urinate, the urine appearing cloudy, red, or brown-colored, and a strong smell of urine. Antibiotics are the treatment choice during the initial stage; if left untreated, they can cause a life-threatening condition called urosepsis.

Endometriosis:

Endometriosis occurs when endometrial-like tissue (the inner lining of the uterus) grows outside of the uterine cavity. Factors such as abnormal menstrual cycles, low body mass, and reproductive tract disorders can increase endometriosis risk. The symptoms include mild pain in the uterus area and abdominal aches, stabbing pains in the pelvis, stabbing pain in the left groin or the right groin in the female’s back, and legs, excessive bleeding, and infertility (inability to conceive an offspring). Treatment for endometriosis includes relieving the pain using pain medication and, in cases with infertility, correcting the underlying issues and hormonal therapy to fix endometriosis.

Pelvic Abscess:

Abscesses are painful, pus-filled pouches of inflamed tissue. The causes of a pelvic abscess include any infection of the lower genital tract, operative procedures (hysterectomy-which is the surgical removal of the uterus, caesarian sections- a type of delivery done by surgical means, laparotomies-a surgical incision (cut) into the cavity of the abdomen, and induced abortion- it is a medically induced abortion in unintended pregnancies), cancers of pelvic organs, Crohn’s disease complications, trauma to the genital tract, and diverticulitis. In addition, pelvic abscesses can cause stabbing pain within the pelvic region if they grow large and press against the sensitive nerves in the abdominal areas. Other symptoms may include fever, loss of appetite, nausea, vomiting caused by a sharp pain in the uterus, and general malaise (malaise is a general feeling of discomfort). Treatment should be done as early as possible because rupture of the abscess can be life-threatening. Usually, surgery is done to drain the abscess (pus), followed by antibiotics.

Kidney Stone:

Kidney stones or calculi are a solid mass of crystals resulting from mineral build-up in urine. If the stones are large, they get stuck in the urinary tract and cause sharp or stabbing pains on both sides of the lower back. Other symptoms include difficulty urinating, foul-smelling urine, fever, nausea, or vomiting. Lithotripsy (Lithotripsy is a procedure that uses shock waves to break up stones in the kidney and parts of the ureter, whereas the ureter is the tube that carries urine from the kidneys to the bladder), ureteroscopy (an examination of the inside of the kidney and ureter, using a ureteroscope.) and tunnel surgery ( a surgery used to treat and potentially heal the painful condition known as carpal tunnel syndrome.) are used to remove kidney stones.

How Is Pelvic Pain Diagnosed?

Different types of tests are required to identify the possible causes of pelvic pain,

Medical History:

The physician asks questions about when the pain occurs, what relieves it, what triggers it, and the duration of the pain. The physician takes family history to know if fibroids (non-cancerous growths that develop in or around the womb (uterus), cancer, or other conditions run in the family. They may also ask about their sexual partners to rule out sexually transmitted infections.

Physical Examination:

A pelvic exam allows the doctor to check for any abnormalities within the reproductive system and palpate the abdomen and lower back if those are the source of pain.

Lab Tests:

Few tests are done based on the patient's medical history and pelvic or physical exam.

  • Colonoscopy - To check the bowel's abnormalities, growths, or obstructions.

  • Urinalysis - To check urinary tract infections and kidney problems.

  • Sigmoidoscopy - To check the lower part of the colon for bleeding or any other abnormalities.

  • Vaginal Swabs - To screen for any infections.

Imaging:

Ultrasound and computer tomography (CT) of the abdomen and pelvis provide good images of any abnormalities or growth in the pelvic area.

Conclusion

Sharp, stabbing pain in the pelvic area can be caused by various underlying causes and indicate a severe condition requiring immediate medical attention. Lower back and pelvic pain a female experiences can be quite challenging. Shooting pains in the vagina during early pregnancy can be a sign of danger sometimes. Diagnosing the source of pelvic pain and proper treatment is essential to avoid serious complications.

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Dr. Richa Agarwal
Dr. Richa Agarwal

Obstetrics and Gynecology

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