The pelvic region is the lowest part of the abdomen below the navel. Pain originating in this area is called pelvic pain. The pelvic region includes the ovaries, uterus, vagina, anus, lower parts of the large intestines, bladder, and lower urinary tract. Diseases of these organs often cause pelvic pain.
What are the Causes of Pelvic Pain?
Pelvic pain can be acute or chronic. Those with a sudden onset are considered acute, while those lasting longer than 6 months are called chronic.
- Ectopic pregnancy: Pregnancy occurred outside the uterus. It can be in the cervix, ovaries, tubes, abdomen, and pelvic cavity. When an ectopic pregnancy is opened, it can cause severe pelvic pain, vaginal bleeding and shock.
- Rupture (fragmentation) of the ovarian cyst.
- Pelvic inflammatory disease (PID): It is a microbial disease occurring in the upper part of the reproductive system. . Infection and abscess can occur in the cervix, uterus, tubes, and ovaries. PID can be transmitted sexually. Common symptoms are fever, pelvic tenderness to touch, pelvic pain, vaginal foul-smelling discharge, and irregular vaginal bleeding. PID can become chronic and cause chronic pain. It can cause infertility and ectopic pregnancy. PID usually occurs in women under the age of 35. It is rare before menstruation begins, during pregnancy, and after menopause. Those who have passed PID before can pass it again. Fungi of the vagina and sexually transmitted microbes can cause PID. It is more common in those living in low socioeconomic conditions. Women with multiple sex partners are at greater risk. Treatment is carried out with hospitalization or outpatient antibiotic therapy.
- Over torsion: A tube connects the ovaries to the uterus. Sometimes the ovaries rotate around this tube. This condition is called ovarian torsion. During rotation, the vessels bend and the blood supply of the ovaries is interrupted. Ovarian torsion can be encountered during ovulation aid treatments. Some benign tumors may enlarge more than 4 cm of the ovaries and may occur due to this. Ovarian torsion is more common in benign tumors than in bad ones. Usually one ovary is involved. It can also be seen in children. Symptoms of the stomach region severe pain in the abdomen and pelvic region, loss of appetite, vomiting and fever. Ovarian torsion can cause inflammation of the abdominal membranes, which we call peritonitis. Diagnosis is often made by ultrasound. In treatment, surgical method is preferred to save the ovary. Today, these procedures can be performed laparoscopically.
- Dysmenorrhea (severe menstrual pain): The pain may begin before menstruation and peaks 24 hours after menstruation begins. The pain can be sharp, cramps or throbbing. The pain may radiate to the legs. It may be accompanied by headache, nausea, constipation or diarrhea, low back pain and frequent urination. Rest, avoidance of stress, heat application and painkillers are recommended.
- Pelvic pain during ovulation: Some women may feel very severe abdominal and groin pain during ovulation.
- Endometriosis: Inside the uterus It occurs as a result of spreading of the covering tissue outside the uterus to the pelvic region. General symptoms may be severe menstrual cramps, painful sexual intercourse, infertility, painful urination and pain during defecation. Medications and surgical methods can be used in the treatment.
- The bands formed in the uterus can also cause severe pelvic pain and bleeding.
- Ovarian (ovarian) cysts
- Ovarian tumors
- Adhesions formed after previous infection or surgery
- Late cervical cancer: Chronic painful There is defecation but no fever. Vagina and breech examination is very painful.
- Fibroids in the uterus
- Uterine prolapse
- Sometimes it may occur due to spirals.
- The baby is in the womb. death
- Abortion: It is manifested by vaginal bleeding, abdominal cramps, pain in the pelvis and lower back.
- Pain after sex
- Tumors arising from the digestive system, abscess in the breech region, constipation
- Cystitis, stones in the urinary tract
- Pains related to the musculoskeletal system in those who have given vaginal delivery
- Pseudo pain as a result of physical, psychological and sexual abuse
- Appendicitis: It starts around the navel and in the stomach area, and later on, the pain spreads to the lower right region of the abdomen. Fever and vomiting it could be. It may be difficult to defecate or accompanied by diarrhea. Diagnosis is made by ultrasound and tomography. It is among the conditions that require urgent diagnosis. Treatment is surgery.
- Crohn's disease (Abdominal pain, cramps, bloating and diarrhea or constipation)
- Ulcerative colitis (Abdominal pain, cramps, bloating and diarrhea or constipation)
- Diverticulitis: Diverticulum is finger-like projections that form in the large intestine. When these become inflamed, it is called diverticulitis. Diverticulum can occur anywhere in the large intestine. It is usually seen in people who have a low fiber diet and suffer from constipation. The diagnosis of diverticulitis is made by tomography. Antibiotics are used in its treatment. If the diverticulitis ruptures, peritonitis may develop. Sometimes a surgical method can be used.
- Peritonitis (inflammation of the abdominal membranes): It may occur during various diseases. It is an emergency and requires hospitalization.
- Spastic colitis
- Bladder tumor
- Large intestine tumor
- Fibromyalgia
- Inguinal hernia
- Varices and vascular occlusions in the pelvic veins: Pain is more especially when sitting and standing.
How to Diagnose Pelvic Pain?
Some diseases such as ectopic pregnancy, ovarian torsion, appendicitis that cause pain in the lower abdomen or groin require urgent diagnosis and a physician should be consulted. Pregnancy should always be considered in women of reproductive age.
In the history and physical examination, the location of the pain, its spread, whether it is related to menstruation, the presence of vaginal bleeding and discharge are questioned. Dizziness and fainting may be additional symptoms.
The situation is urgent if the following symptoms are present along with pelvic pain:
- Fainting,
- Low blood pressure,
- Palpitations,
- Abdominal stiffness,
- Very high fever,
- Severe pain when pressing on the abdomen,
- Nausea, vomiting,
- Severe vaginal bleeding,
- Blood in stool,
- Sudden onset pain during ongoing pregnancy.
What are Diagnostic Tests for Pelvic Pain?
Some of these tests are:
- Urine analysis,
- Pregnancy test,
- Abdominal ultrasound,
- Computed tomography,
- Vaginal ultrasound,
- Complete blood count, CRP and liver enzymes,
- Urinary system ultrasound,
- colon scopy,
- Rectoscopy
How to Treat Pelvic Pain?
Treatment of pelvic pain is medical (medicated) or surgical, depending on the cause of the pain. done as.
What are the Causes of Pelvic Pain in Advanced Age?
What are the Causes of Chronic Pelvic Pain?
Pelvic pain persisting for more than 6 months is considered chronic pain. Major causes of chronic pelvic pain:
- Endometriosis,
- PID,
- Irritable bowel disease (with stomach cramps, bloating, diarrhea and constipation)
- Crohn's disease or ulcerative colitis,
- Ovarian cysts,
- Recurrent urinary tract infections,
- Lower back pain,
- Uterine prolapse ,
- Intrauterine fibroids,
- Chronic cystitis,
- Abdominal hernias,
- Compressed or damaged nerves in the pelvic region.
What Causes Pelvic Pain During Pregnancy?
As pregnancy progresses, bones and connective tissue stretch. There may be chronic pain associated with it. However, if a pregnant woman has pelvic pain, she should be evaluated by a physician. In pregnant women, miscarriage, premature birth, early separation of the baby's spouse and ectopic pregnancy are conditions that require urgent evaluation. Some contractions occur in the last 3 months of pregnancy. These are called pseudo-pains. These pains do not occur regularly and their severity does not increase. With these features, they differ from labor pains.
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