There it is again–that pain in your pelvis– nagging and a bit difficult to pinpoint. Women have a lot going on there–in addition to all the digestive organs and elimination organs, all of a woman’s reproductive organs are there, too. How do you know what’s causing that pain?
Some studies estimate that 15% of women of childbearing age in the United States suffer from chronic pelvic pain, while worldwide that statistic ranges between 14 and 32%. If you’re part of that number, you may be concerned about the cause of your pain or maybe even frustrated that no one has figured out why you have that pain. Should you seek treatment, or is it nothing to worry about? Let’s explore what different conditions commonly cause pelvic pain.
What causes pelvic pain?
Pelvic pain doesn’t always have one particular cause. Multiple factors can be at play, some more serious than others. Furthermore, pelvic pain can either be acute (sudden) or chronic (long-lasting), making its exact cause difficult to pinpoint. If you’re pregnant, or even if you think you may be, there’s even more that may be going on.
Acute pelvic pain
Acute pelvic pain is typically sudden and unexpected. If you’ve just had an episode of acute pelvic pain without knowing why, it’s best to see your doctor.
The most common causes of acute pelvic pain include:
- Urinary tract infection (UTI). This kind of pain is usually associated with burning when you urinate and more frequent or urgent urination. UTIs aren’t typically dangerous as long as they’re treated appropriately, so see a healthcare provider soon.
- Appendicitis. Pain from appendicitis is usually on the lower right side of your abdomen although if the appendix “bursts” the pain can be all over. Appendicitis is a serious, possibly life-threatening condition, so get to an emergency room if you think this is what’s causing your pain.
- Ovarian cyst. Women often have cysts on their ovaries that come and go with a woman’s menstrual cycle and cause no issues, but a large ovarian cyst can cause dull, heavy pain or pressure on either side of your abdomen or pelvis depending on which ovary is involved. If a cyst ruptures, it often causes sharp, severe pain. You’ll want to see a doctor to make sure everything is okay if you think you have ruptured an ovarian cyst.
- Passing a kidney stone. Passing a kidney stone can be a very painful experience. The pain usually starts on one side of the abdomen and can be referred to the pelvis. It is often associated with nausea and vomiting and in a woman of reproductive age, an ultrasound or CT scan is needed to differentiate this from appendicitis or ruptured ovarian cyst.
If you are, or think you may be, pregnant, there are certain events that may cause acute abdominal pain. You should contact your healthcare provider immediately if you are having pain that may be related to your pregnancy:
- Miscarriage. If you are having a miscarriage, you may have cramping along with spotting or heavy bleeding. For some women, the cramping is severe; for others, it’s minor.
- Ectopic pregnancy. Ectopic pregnancy happens when a fertilized egg implants itself outside of the uterus. The first signs may be pain in the pelvis or abdomen, but pain can even spread into the shoulder or neck. The pain may be mild and dull or sharp and severe. This is a serious, even life-threatening, condition, so get to an emergency room if you think this is what’s causing your pain.
Chronic pelvic pain
Chronic pain means pain that has been a problem for more than six months. It doesn’t have to be constant for it to be considered chronic; it can come and go. The most common causes of chronic pelvic pain include:
- Endometriosis. This common disorder causes tissue to grow outside the uterus. Pain from endometriosis can be acute, stabbing, burning, or just a dull ache. The pain may also spread to the low back. Some women say that pain from endometriosis feels like their insides “are being pulled down.” Some supplements that may help with endometrial pain include milk thistle, curcumin, omega-3 fatty acids, and vitamin B-6.
- Adenomyosis. Adenomyosis is similar to endometriosis in terms of symptoms such a pain and heavy bleeding, but the difference is that with endometriosis cells that normally line the uterus grow outside the uterus while with adenomyosis the cells grow into the wall of the uterus.
- Menstrual cramps. Some cramping happens because the uterus has to contract to expel its lining. If you are suffering severe menstrual cramps, you may want to work with your healthcare provider to see if there are any remedies that you can try. Sometimes, heat (a heating pad, a warm bath) can help relieve pain. Other women find some relief with light exercise. Supplements that may help relieve cramping include vitamin E, omega-3 fatty acids, vitamin B-1, vitamin B-6, and magnesium. Acupuncture may be helpful. Working on your stress level can help, too–try yoga or meditation.
- Recurrent urinary tract infection. Women who have repeated urinary tract infections may continue to have pain between active infections because of residual inflammation. The best treatment for this is prevention of infections such as with cranberry supplements, d-mannose, uva ursi, or other natural remedies. Peri or post -menopausal women often benefit from vaginal estrogen. Infections related to sexual activity may require a preventative antibiotic at the time of sexual activity.
- Irritable bowel syndrome (IBS). Usually, this type of pain is a cramping in the lower abdomen. Most people with IBS find relief from pain by discovering which foods trigger their cramping and avoiding those. Stress relief, such as meditation, can also be helpful. Acupuncture has had mixed results with IBS, but it may be worth a try to relieve your pain.
- Interstitial cystitis. Interstitial cystitis (IC), also known as painful bladder syndrome, is a chronic condition that can cause bladder pressure and pain. The actual cause of IC is unknown. Acidic food and drink can aggravate IC symptoms, so many women benefit from supplements that neutralize acid and and have natural anti-inflammatory effects.
- Pelvic inflammatory disease. This disease is a general infection of a woman’s reproductive system usually caused by a sexually transmitted infection such as gonorrhea or chlamydia. It usually causes lower abdominal pain and pain with intercourse. You may also experience pain with urination. This condition can be treated with antibiotics, so see a doctor if you think this may be what’s causing your pain.
- Uterine fibroids. Uterine fibroids are noncancerous tumors that grow on the uterine wall. These growths can become rather large and uncomfortable. The pain from fibroids is often described as “heavy” and as “pressure” rather than pain. There are medications that can help, so see your healthcare provider if the pain interferes with your life.
Now you’re informed about some potential causes of your pelvic pain. It’s a good idea to see a doctor when you’re experiencing pelvic pain. They will be able to determine the exact cause and treat you accordingly.
Learn More About Pelvic Floor Health
For more information about pelvic floor health, check out Dr. Karyn Eilber’s book “A Woman’s Guide to Her Pelvic Floor: What the F*@# Is Going On Down There?” on Amazon and Doctorpedia
