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Pelvic pain is a common complaint among women. Its nature and intensity may fluctuate, and its cause is often obscure. In some cases, no disease is evident. Pelvic pain can be categorized as either acute, meaning the pain is sudden and severe, or chronic (pain that either comes and goes or is constant), lasting over a period of months or longer. According to the American College of Obstetricians and Gynecologists, pelvic pain lasting longer than 6 months and showing no improvement with treatment is known as chronic pelvic pain. Pelvic pain may originate in genital or extragenital organs in and around the pelvis, or it may be psychological, which can make pain feel worse or actually cause a sensation of pain, when no physical problem is present.
Pelvic pain may have multiple causes, including:
Some of the more common sources of acute pelvic pain, or pain that occurs very suddenly, may include:
Some of the conditions which can lead to chronic pelvic pain, pain that may last for several months or longer, may include:
This long-term and often unrelenting pain may cause a woman's defenses to break down, resulting in emotional and behavioral changes. This occurrence is often termed "chronic pelvic pain syndrome."
The following are examples of the different types of pelvic pain most commonly described by women, and their possible cause or origin. Always consult your physician for a diagnosis.
Type of Pain
|localized pain||may be due to an inflammation|
|colicky pain||may be caused by spasm in a soft organ, such as the intestine, ureter, or appendix|
|sudden onset of pain||may be caused by a temporary deficiency of blood supply due to an obstruction in the circulation of blood|
|slowly developing pain||may be due to inflammation of the appendix or an intestinal obstruction|
|pain involving the entire abdomen||may suggest an accumulation of blood, pus, or intestinal contents|
|pain aggravated by movement or during examination||may be a result of irritation in the lining of the abdominal cavity|
Diagnostic procedures and tests will be performed in order to determine the cause of the pelvic pain. In addition, your physician may ask you questions regarding the pain such as:
Additional information about the timing of the pain and the presence of other symptoms related to activities such as eating, sleeping, sexual activity, and movement can also help the physician in determining a diagnosis.
In addition to a complete medical history and physical and pelvic examination, diagnostic procedures for pelvic pain may include:
Specific treatment for pelvic pain will be determined by your physician based on:
Treatment may include:
If a physical cause cannot be found, pelvic pain may be diagnosed as a psychological defense or coping mechanism for some type of trauma. In some cases, psychotherapy is recommended. In other cases, physicians may recommend a multi-disciplinary treatment utilizing a number of different approaches including nutritional modifications, environmental changes, physical therapy, and pain management.