Pelvic Pain: Some Possible Culprits

Monday 27 February 2012

Pelvic pain or discomfort is a common occurrence in women. Pain in the pelvic or lower abdomen area is actually a very general symptom that can be a sign of many conditions, not just premenstrual syndrome.

Pelvic pain refers to any sort of pain or discomfort in the abdomen below the belly button. As this is a rather large area, the pain could originate from several sources. Some of the main causes of pelvic pain are:-

1. Premenstrual Syndrome (PMS) and Menstruation

The most common cause of pelvic pain in women is PMS. Before our monthly menstrual cycle begins, our hormones start to go through changes to prepare our body for ovulation and conception. These hormonal fluctuations can cause PMS symptoms, starting from 5 to 11 days before menstruation. Some symptoms are:-
  • abdominal cramps
  • low back pain
  • headache
  • tender breasts
  • acne
  • mood swings
Some of us experience cramps in our lower abdomen or back during our menstrual period, caused by our uterus contracting to push out the menstrual blood.

2. Ovulation

Between our periods, our ovaries will release an egg, along with some fluid and blood, which may cause us to feel a painful twinge in our abdomen. This pain may be experienced midway through our menstrual cycle, and it may switch from left to right side during different months (depending on which ovary releases the egg). This pain goes away within a few hours.

3. Appendicitis

This is when our appendix becomes infected and inflamed. It could potentially burst and cause complications or death. If it's a sudden sharp pain in our lower abdomen, on the lower right area of our stomach, accompanied by vomiting and fever, it may be appendicitis.

4. Ectopic pregnancy

This is a life-threatening condition where the embryo implants outside of the uterus, usually in the fallopian tubes. The symptoms are:
  • a sharp pain in the lower abdomen or pelvic area
  • cramps on 1 side of the pelvic
  • abnormal vaginal bleeding
  • nausea
  • dizziness
This may occur during early stages of pregnancy.

5. Sexually transmitted diseases (STDs)

The 2 most common STDs that affect women are chlamydia and gonorrhea. The symptoms are:
  • pelvic pain
  • painful urination
  • bleeding between periods
  • abnormal vaginal discharge

6. Pelvic inflammatory disease (PID)

STDs can go on to cause PID. The symptoms are:
  • pelvic pain
  • fever
  • abnormal vaginal discharge
  • pain during sex
  • pain during urination
PID is a serious consequence of untreated STDs and can cause permanent damage to the uterus, ovaries and fallopian tubes, leading to infertility.

7. Ovarian cysts

This forms during ovulation when the ovary doesn't release the egg, or the follicle (sac in the ovary) recloses after releasing the egg and swells with fluid. A large size cyst can cause:
  • pelvic pain
  • weight gain 
  • frequent urination.
Some cysts don't cause any pain and resolve on their own.

8. Fibroids

Uterine fibroids are non-cancerous tumours or growths that grow on the wall of the uterus. Fibroids are very common and many women develop them during their childbearing years without suffering from any pain or symptoms. However, some fibroids can cause:
  • pelvic cramping
  • pain during menstruation
  • pressure in the lower abdomen
  • pain during sexual intercourse
  • lower back pain
  • abnormal menstrual bleeding


(Source: StarFit4Life, What's That Pain? by Dr Nor Ashikin Mokhtar 25 December 2011)

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