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Pelvic Pain


Pelvic pain is a common problem, seen more in women that in men. Patients with acute pelvic pain are frequently seen in the Emergency Room of a hospital. Ref.22 lists 24 various conditions that can cause pelvic pain in women. Some of the life threatening conditions are a ruptured tubal pregnancy or a pelvic abscess that may have opened up causing acute peritonitis.

Causes of pelvic pain

Ovarian cyst pain can be caused from bleeding into it, from rupture or from a rapidly enlarging tumor or cancer. On the other hand infections inside the uterus (endometritis) or from PID /STD (PID caused by STD) can cause pelvic pain as well. In an early pregnancy a spontaneous abortion can cause excruciating pelvic pain and is often associated with profuse vaginal bleeding. In later pregnancy pelvic pain can be associated with placental problems (infarct, placenta abruptio), with premature labor or with severe preeclampsia. Pelvic adhesions from prior pelvic surgery, appendectomy or perforated diverticulitis can cause pelvic pain as well.Endometriosis and ovarian cancer as well as primary dysmenorrhea can also cause pelvic pain.

Diagnostic tests for investigating pelvic pain

Obviously the treating physician will want to refer many of these patients to a gynecologist for a pelvic pain diagnosis and to pinpoint the cause of pelvic pain.

Several tests are available, from pelvic examination to ultrasound and MRI scan. Several other X-ray methods are also available. Often, even with these methods, the gynecologist comes to a point where only a laparoscopic procedure will show the pathology that underlies the pelvic pain.

Treatment of pelvic pain

The gynecologist will offer the specific treatment for the condition identified. This may involve some hormones, a surgical procedure or reassurance. Sometimes no cause can be found and only pain relieving medication can be offered.


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Last modified: August 17, 2014

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.