Pelvic Pain: What Does It Mean

What is Pelvis?

Before we discuss pelvic pain, let us understand the pelvis or the pelvic region.

The pelvis is a bowl-like structure which connects your upper body to your legs. It shelters essential organs like the urinary bladder, uterus, rectum and some parts of the intestine. 

It is a bony and muscular structure which performs the following functions,

• Supports your weight.
• Protects your organs.
• Helps you move.
• In females, it forms the birth canal, allowing child-birth.

Types of Pelvic Pain: Acute vs Chronic Pelvic Pain

Pelvic pain can be of 2 types based on time duration. They are,

1. Acute Pain: It is a type of sudden and severe pain. It usually lasts for a short period of time. It is caused by infections, injuries, and other conditions.

For example,

• Ovarian cysts
• Appendicitis 
• Urinary tract infection
• Kidney stones

2. Chronic Pain: It is a type of pain which lasts for 6 months or longer. This type of pain is usually continuous or recurring. Around 24% of women worldwide suffer from chronic pelvic pain. It is caused by various conditions.

For example,

• Endometriosis
• Interstitial cystitis
• Chronic pelvic inflammatory disease
• Fibromyalgia

Pelvic Pain and Conditions Associated With It

Pelvic can affect both sexes. It is often difficult to detect the cause of pelvic pain. Sometimes, the cause remains unknown.

There are various conditions which can cause pelvic pain. These conditions can be gynaecological or non-gynaecological in nature.

1. Gynaecological Causes

Common gynaecological conditions (conditions related to the female reproductive system) which cause pelvic pain are,

• Adenomyosis: A condition where the tissue which normally lines the inside of the uterus (endometrium) grows into the muscular wall of the uterus (myometrium). This condition causes severe pain, especially during menstruation.
• Endometriosis: This condition is similar to adenomyosis, but here, the endometrium grows outside the uterus (fallopian tubes, ovaries, bladder, etc). This condition causes severe pain, especially during menstruation.
• Ovarian Cysts: These are fluid-filled sac-like structures that develop on the ovaries, which lead to pain when they become large, rupture, or twist.
• Ovarian torsion: A condition where an ovary twists on its attachment to the other structures. This decreases blood flow to the ovary, which causes a sudden shooting of pelvic pain on the affected side.
• Pelvic Inflammatory Diseases (PID): An infective condition of the female reproductive system which leads to severe pelvic pain and discomfort.
• Uterine fibroid: These are non-cancerous growths in the uterus that can lead to pelvic pain if they are large or cause pressure on surrounding organs or structures.
• Ovulation Pain: When the ovary releases an egg, some women might experience pain in the right or left pelvic region, typically around the middle of the menstrual cycle. Sometimes, this can be associated with mid-cycle spotting.
• Sexually Transmitted Infections: It is caused by organisms such as Chlamydia, Trichomonas, HIV (human immunodeficiency virus) and HPV (human papillomavirus). It causes pelvic pain, abnormal vaginal discharge, painful urination, unusual bleeding and so on.
• Ectopic Pregnancy: It is a condition where the fertilised egg implants itself outside the uterus (usually in one of the fallopian tubes). This causes severe pelvic pain and vaginal bleeding.

2. Non-gynaecological Causes

Common non-gynaecological conditions (conditions related to organs such as the urinary bladder, bowel, muscles and bones in the pelvic region) which cause pelvic pain are,

• Irritable Bowel Syndrome (IBS): It is a gastrointestinal condition that causes abdominal pain, bloating, and changes in bowel habits.
• Urinary Tract Infection (UTI): It is an infection of the urinary system which causes pelvic and lower abdominal pain. It can also cause painful or burning urination.
• Interstitial Cystitis: A condition with chronic pain of the urinary bladder along with painful urination.
• Appendicitis: An inflammatory condition in the appendix which causes severe pain in the right pelvic region. It is usually associated with fever and vomiting.
• Musculoskeletal Conditions: Pelvic pain can result from issues with muscles, ligaments, or bones in the pelvis region. These include groin muscle strain or tear, pelvic injuries or fractures and sciatica.
• Inguinal Hernia: A bulge in the lower abdomen causes pelvic pain, especially when coughing, lifting heavy objects, and straining. In some cases, the pain is very severe if the hernia is strangulated, which may require emergency treatment.
• Pelvic Floor Dysfunction: The pelvic floor muscle supports the bladder, bowel and reproductive system. This condition occurs due to muscle tension, injury or trauma, which leads to muscle weakening or tightening. This can cause discomfort in the pelvis, lower back and groin. It is usually associated with constipation and bladder incontinence.
• Tumour: Tumours of the rectum, bladder and colon can also cause pelvic pain associated with bleeding per rectum or through the urethra.
• Kidney Stones: These cause pain in the back or sides, as well as in the groin and pelvis.

Pelvic Pain in Males

Did you know even men experience pelvic pain? Yes, men also experience pelvic pain due to various conditions. These conditions include the above-mentioned non-gynaecological conditions along with some common conditions related to the male reproductive system, such as,  

• Prostatitis: It is an inflammation of the prostate due to bacteria or any underlying causes. It can lead to sharp or dull pelvic pain, painful urination and pain during ejaculation.
• Benign Prostate Hyperplasia (BPH): It is a condition where a normally sized prostate gland grows bigger in size. This leads to pelvic pain, incomplete urination, dribbling of urine and urgency.
• Prostate Cancer: It can sometimes cause pelvic pain when it spreads to nearby tissue of bones.

Are You Wondering When to See Your Doctor?

It is always essential to consult a healthcare professional if you're experiencing these symptoms,

• If the pain is sudden and severe in nature.
• If the pain lasts for a long duration (for several weeks to months) or that occurs in intervals.
• If the pain is associated with nausea, vomiting and fever.
• If there are any noticeable changes in bowel and urinary habits.
• If there is pain during intercourse or urination.
• If the pain interferes with day-to-day activities.

It is important to seek medical attention to rule out any serious conditions and receive appropriate treatment.

Tailoring Treatment for Pelvic Pain

• Medications: Pain relievers help relieve mild pain. If the pain is severe, stronger pain relievers, along with muscle relaxants, help relieve the pain. In cases of bacterial infections, antibiotics help fight the infection and reduce pain. Hormonal therapy can help reduce the production of oestrogen, which shrinks the endometrial tissue, leading to a reduction in endometriosis and muscle cramps.
• Physical Therapy: In pelvic floor dysfunction, pelvic physical therapy such as kegel’s exercise can help reduce muscle tension and pelvic pain.
• Surgical Intervention: In some cases like uterine fibroids, endometriosis or ovarian cysts.
• Lifestyle Changes: For non-gynaecological conditions such as IBS or UTI, dietary modifications, increased water intake, and stress management techniques can help provide relief to a certain extent.
• Alternative Therapies: In chronic pelvic pain, yoga, acupuncture and relaxation therapies can help provide relief for some individuals.

Wrapping Up

Pelvic pain can significantly affect the quality of a woman's life. It makes everyday activities challenging and uncomfortable. It occurs due to various causes, and seeking appropriate medical attention as soon as possible is an effective management.

A healthcare professional helps alleviate pain, improve their overall well-being, and regain control of their lives by recognising the symptoms, undergoing accurate diagnosis, and exploring suitable treatment options. If you are experiencing pelvic pain, consult with our experts at Nirva Health, as early diagnosis and treatment can prevent complications and improve your long-term health.