Pelvic pain occurs in the lowest part of the abdomen, vagina and bladder. Depending on the cause, pelvic pain can vary in intensity and nature. It can be acute, which means the pain is sudden and severe, or chronic, meaning the pain comes and goes or is constant for a long period of time.
There are several causes of pelvic pain, including:
- Adenomyosis — A condition that occurs when endometrial tissue grows into the uterine wall. This can cause menstrual cramps, bloating and heavy menstrual periods
- Endometriosis — A condition that occurs when the tissue that lines the uterus grows outside of the uterus. It can cause severe pain and fertility issues
- Pelvic inflammatory disease — An infection of the reproductive organs
- Urinary tract infection — An infection of the urinary system that can cause pelvic pain
- Ovarian cysts
- Urinary tract infection
- Pelvic organ prolapse
- Vaginal dryness
- Menstrual cramps
- Ectopic pregnancy
- Spasm of pelvic or vaginal muscles
- Interstitial cystitis
- Hormonal imbalance
Symptoms of pelvic pain include:
- Pain in the abdomen, pelvis, vagina, vulva, rectum or during menstruation or intercourse
- Painful or difficult urination
- Pain with urination
- Sexual pain
Your doctor will start by performing a physical exam. If your condition is still unclear, your doctor may suggest the following diagnostic tests:
- Ultrasound — A test that uses high frequency sound waves to produce images of your organs.
- Laparoscopy — A diagnostic procedure used to examine the abdominal cavity.
- Cystoscopy — A procedure that allows your doctor to view the inside of your bladder.
- Colonoscopy — A diagnostic technique that allows your doctor to examine the inner lining of the large intestine (rectum and colon).
Treatment options for pelvic pain may include dietary management, laser therapy, lubricants, dilators or surgery. Some of the common treatment options include:
- Pelvic floor rehabilitation — For patients with muscles that are too tight or in spasm; this program helps relax the pelvic muscles and relieve pain.
- Botox injections — These injections in the pelvic floor and vaginal muscles treat pelvic muscle spasm and vaginismus by lessening the amount of muscle spasm.
- Laparoscopic surgery — Laparoscopic surgery, a minimally invasive surgical technique, can correct a number of pelvic conditions. These operations are associated with less scarring, small ports and reduced postoperative pain compared to open surgery with incisions.
- Hysterectomy — A hysterectomy is the surgical removal of the uterus.
- Medications — Depending on your condition, your doctor may recommend pain relievers, hormone treatments or antibiotics.
- Biofeedback techniques — Biofeedback techniques help you to be aware of and control specific physiological processes within your body.
- Vaginal dilators -- pain related to vaginal narrowing or vaginal muscle spasm can be treated with Botox, vaginal dilation under anesthesia, as well as with vaginal dilators used in the privacy of one’s home