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Pelvic Pain

What Women Need to Know About Pelvic Pain

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Updated July 01, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Pelvic pain is a symptom that affects many women and can be caused by a wide variety of conditions and diseases, from premenstrual syndrome (PMS) to more serious conditions, like gynecologic cancer.

What Does Pelvic Pain Feel Like?

Pelvic pain is pain or pressure felt anywhere in the abdomen below the navel. It may be intermittent or constant. Many women describe pelvic pain as a dull ache that may include sharp pains. Pelvic pain can be accompanied by other symptoms, like abnormal vaginal bleeding, lower back pain and vaginal discharge. Being aware of other symptoms can be important clues in discovering the source of the pelvic pain.

To help your doctor accurately diagnose the cause of pelvic pain, try to record information like when the pain occurs, what you were doing when the pain occurred and what helps alleviate it. This can include laying down or taking over-the-counter medications to relieve pain. Creating a symptom/pain journal is an excellent method of tracking your pain.

Pelvic Pain As a Symptom of Gynecologic Cancer

Pelvic pain can be a symptom of most types of gynecologic cancer, mostly when the cancer has progressed. Some researchers believe that ovarian cancer may be an exception, however, and that pelvic pain may be an early sign of the disease. The problem is that without an adequate ovarian cancer screening tool and the fact that pelvic pain is common in many conditions, there can often be a delay in diagnosis.

In a 2004 study in the Journal of the American Medical Association, researchers found that women did experience symptoms of ovarian cancer early (pelvic pain included), but the frequency, severity and onset of these symptoms played a key role in comparing malignant and benign conditions. Symptoms like pelvic pain that occurred often, severely and somewhat suddenly were more likely to be related to ovarian cancer.

Keep in mind that pelvic pain, although common, is just one of a handful of possible early ovarian cancer symptoms. Women who participated in the study also experienced more than one possible early ovarian cancer symptom. Bloating, lower back pain and gastrointestinal changes like constipation were common symptoms, not just pelvic pain.

Pelvic Pain: Common Symptom of Other Conditions

Although pelvic pain is a symptom of gynecologic cancer, it is also a symptom of many other conditions. It it much more likely that you are experiencing pelvic pain because of one of these causes, rather than cancer. Possible benign conditions that cause pelvic pain include:
  • constipation

  • PMS

  • urinary tract infections

  • kidney stones

  • endometriosis

  • fibroid tumors

  • ovarian cysts

  • ectopic pregnancy

  • pelvic inflammatory disease

When to See a Doctor and What to Expect

For most women, pelvic pain is caused by a benign condition that is not cancer-related. However, women who experience sudden or long-term pelvic pain should be evaluated by a physician. Pelvic pain that is not related to cancer can still be serious. It is important to note that mild cramping and pain associated with menstruation is normal and does not require medical attention unless it is very painful (a condition called dysmenorrhea).

When you do see a doctor about your pelvic pain, your doctor will ask you several questions related to your pain, such as when it occurs, what triggers it, what relieves it and how long you have been experiencing it. Determining whether it is acute or chronic pelvic pain helps the doctor decide what medical tests are needed. For example, a sudden onset of pelvic pain in a woman could indicate an ectopic pregnancy in some cases, while a woman who has been experiencing pelvic pain for months could be suffering from endometriosis.

Whether or not the pelvic pain is chronic or acute, your doctor will want to do a pelvic exam that may include a Pap smear. A pelvic exam allows your doctor to check for any abnormalities within the vagina, cervix, ovaries and uterus. He or she may also take vaginal cultures to screen for infection. This is very routine; your doctor is looking for undetected sexually transmitted diseases or other infections that may cause pelvic pain.

Based on the findings from the pelvic exam, family history and personal health history, your doctor may want to do more tests to discover the cause of the pelvic pain. An ultrasound of the vaginal and/or abdominal area is often the first test doctors order to evaluate pelvic pain. A pregnancy test may be necessary to rule out possible pregnancy related causes, as well.

Pelvic Pain Emergencies

If you suddenly experience severe pelvic pain, especially if it is on one side or if you suspect or know you are pregnant, you need to seek medical treatment immediately. This is a dangerous symptom of an ectopic pregnancy. Ectopic pregnancies are not common, however, but they can be life threatening if untreated.

Secondly, appendicitis can produce sudden pain near the bellybutton, which can be mistaken for pelvic pain. Like an ectopic pregnancy, appendicitis can be life-threatening. Generally, appendicitis begins with pain near the belly button and radiates toward the right.
More appendicitis symptoms

Sources:

American Cancer Society. Detailed Guide: Vaginal Cancer. 12 July 2006. Accessed 15 October 2009.

American Cancer Society. Detailed Guide: Ovarian Cancer. 16 Feb 2008. Accessed 22 October 2009.

Goff BA, Mandel LS, Melancon CH, Muntz HG. Frequency of symptoms of ovarian cancer in women presenting to primary care clinics. J Am Med Assoc 2004; 291: 2705–2712.

National Cancer Institute. Ovarian Cancer. 23 April 2007. Accessed 22 October 2009.

National Cancer Institute. Vaginal Cancer (PDQ®): Treatment; 23 May 2008. Accessed October 2009.

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