Because pelvic pain can have a wide range of causes, it’s important to take it seriously and seek proper evaluation to uncover the underlying issue.
What Is Pelvic Pain?
Pelvic pain refers to discomfort in the area below the belly button and between the hips. It can be:
- Acute (sudden and short-term)
- Chronic (lasting more than 6 months)
- Cyclical (linked to your menstrual cycle)
- Intermittent or constant
Common Causes of Pelvic Pain
1. Gynaecological Causes
These are some of the most frequent reasons for pelvic pain in women:
- Menstrual cramps (dysmenorrhoea)
- Endometriosis – Tissue similar to the uterine lining grows outside the uterus
- Ovarian cysts – Fluid-filled sacs on the ovary that may rupture or twist
- Fibroids – Non-cancerous growths in the uterus
- Pelvic inflammatory disease (PID) – Infection of the reproductive organs
- Ectopic pregnancy – A pregnancy outside the uterus (urgent medical issue)
- Ovulation pain (Mittelschmerz) – Mid-cycle pain due to egg release
Sources: https://fibroidexpert.com/blog/fibroids-vs-endometriosis/
2. Urinary Causes
- Urinary tract infection (UTI)
- Interstitial cystitis – Chronic bladder pain without infection
- Kidney stones
3. Digestive Causes
- Irritable bowel syndrome (IBS)
- Constipation
- Inflammatory bowel disease (Crohn’s or ulcerative colitis)
4. Musculoskeletal or Nerve-Related Causes
- Pelvic floor dysfunction
- Hernias
- Nerve entrapment or sciatica
https://link.springer.com/article/10.1007/s40141-020-00259-3
5. Other
- Post-surgical adhesions (scar tissue)
- Sexually transmitted infections (STIs)
How We Investigate Pelvic Pain
To get to the root cause of your pelvic pain, we usually follow a step-by-step approach:
1. Medical History and Physical Examination
We’ll ask about:
- Timing, location, and character of your pain
- Your menstrual cycle
- Sexual and urinary symptoms
- Past surgeries or infections
A pelvic exam may be done to assess tenderness, lumps, or abnormal discharge.
2. Imaging Tests
- Transvaginal or pelvic ultrasound – First-line tool to assess uterus, ovaries, and surrounding structures
- Abdominal ultrasound – Especially if urinary or digestive causes are suspected
- MRI or CT scan – Sometimes used if more detailed imaging is needed
Learn more about Pelvic Ultrasounds here
