Pelvic Pain Causes Diagnosis




How prevalent is pelvic pain?

Pain is the most frequent reason for patients to seek medical advice and pelvic pain is a common reason for gynaecological consultation. Pelvic pain may be acute (sudden onset), chronic (long-standing) or recurrent (intermittent).

Related Medical Abstracts – Click on the paper title:-

What are the common causes of pelvic pain in women?

The more common causes of lower abdominal and pelvic pain are summarised in Table 23.1.

Table 23.1 The more common causes of pelvic pain and lower abdominal pain.


 Disorder / Disease

Vagina Vaginitis
Cervix Cervicitis
Uterus Fibroids
Intrauterine contraceptive device
Endometrial polyp
Fallopian tubes Ectopic pregnancy
Pelvic inflammatory disease
Ovaries Endometriosis
Mittelschmerz (Ovulation pain)
Ovarian cyst
Peritoneum Endometriosis
Pelvic congestion
Retrograde menstruation
Bowel Appendicitis
Crohn’s disease
Gastroenteritis (Acute diarrhoea and vomiting)
Irritable bowel syndrome
Ulcerative colitis
Bladder / urinary tract Renal colic (kidney stones)
Urinary tract infection
Musculo-skeletal system Ligament and muscle pain.

Physical pain may arise from the vagina, cervix, the uterus, the ovaries or the Fallopian tubes (Figure 02-01). The pain can also be of non-gynaecological origin arising from the bowel, bladder or the musculo-skeletal system.

There are times when despite careful investigation, a physical explanation for the pelvic pain cannot be found. Sometimes the pain may be psychosomatic (a subconsciously mediated physical manifestation of a mental disorder).

What are the common causes of gynaecological pelvic pain?

Dysmenorrhoea (pain associated with menstruation) is the commonest type of gynaecological pelvic pain in young women. Pain may occur at the time of ovum (egg) release about 14 days before the next period is due; this pain is called mid-cycle pain or Mittelschmerz. Cysts (fluid filled sacs) within the ovaries occur frequently and indeed naturally throughout the reproductive years; these may be called physiological or functional cysts. Sometimes, bleeding may occur into a physiological cyst resulting in acute pain. Pelvic pain may be an indication of a problem during early pregnancy (Miscarriage;12.23).

Other gynaecological causes of pelvic pain include pelvic inflammatory disease (Q 20. 2), fibroids (14) and endometriosis (18). Utero- vaginal prolapse (1) may cause a dragging pelvic ache or pain.

Related Medical Abstracts – Click on the paper title:-

What are the more common non-gynaecological causes of pelvic pain?

  • Constipation is probably the commonest cause of pelvic pain.
  • Many patients have irritable bowel syndrome – IBS (34). Typically there is a story of intermittent diarrhoea and constipation.
  • Infection in the urinary tract (e.g. cystitis) is another common cause of lower abdominal and pelvic pain. If a “mid-stream urine” sample shows evidence of infection, the problem should respond to an appropriate antibiotic.
  • The musculo-skeletal system (the bones, muscles, tendons and joints) may be the source of pain in the pelvic area.

    This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist – Specialist Interests – Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.

    I do hope that you find the answers to your women’s health questions in the patient information and medical advice provided.

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