Pelvic Pain: What If It Hurts “Down There?”

It might start as a dull pain during your period. Might be so severe it affects your life. Might be steady. Might come and go. For some women, this problem in your pelvic region will get worse if you don’t do something about it.

First, you have to find out what causes your pain.

“It’s not unusual to find there’s more than one condition affecting a woman’s pelvic health,” says McLeod Gynecologist Monica Ploetzke, MD. “And that’s not unexpected, because the pelvis is home to a woman’s entire reproductive system, including the vagina, uterus, cervix, ovaries and fallopian tubes. Different conditions and diseases can affect these pelvic structures and cause pain.”

POSSIBLE CAUSES OF PAIN
Here’s a brief overview of some of the more common problems:

  • Endometriosis results when certain kinds of cells from the inner lining of the uterus (where babies grow) flourish outside the uterus, in areas including the outer surface of the uterus, ovaries, bladder or fallopian tubes. Pain can radiate from the pelvis all the way to the lower back and leg, and is often worse around your period.
  • Fibroids grow inside and outside the uterus as non-cancerous (benign) tumors. Most common in women aged 30 to 40, fibroids can affect a woman at any age. They can grow large enough to cause swelling of the abdomen but rarely turn into cancer.
  • Pelvic Organ Prolapse occurs when the muscles and connective tissues relax, allowing certain organs to drop into the area normally occupied by the uterus. Causes include having children, menopause, prior pelvic surgery, obesity, aging, and smoking.
  • Vulvodynia causes pain in parts of a woman’s sex organs that are outside the body that we refer to as labia or vulva. A woman can feel rawness, stinging, itching or burning in this area.

These aren’t the only possible sources of your pelvic pain. You may also be suffering from:

  • Adenomyosis, a condition that occurs when tissue lining the inner surface of the uterus grows into the uterine muscle wall;
  • Pelvic congestion syndrome, caused by varicose veins in the pelvis with pain from the pressure of blood building up and pooling;
  • Adhesions, scar tissue that forms between tissues and organs as a result of surgery or infection from pelvic inflammatory disease.
  • Interstitial Cystitis (IC) described by some women as the worst urinary tract infection they’ve ever had, although the exact cause or causes are difficult to identify. Many women with IC experience chronic urinary symptoms as well as painful intercourse.

FINDING OUT WHAT’S WRONG
Your Gynecologist will start by investigating your personal medical history and will likely perform some lab tests. They may perform an ultrasound or take some tissue samples with a minimally invasive laparoscopy. Once your physician has pinpointed the problem or problems, you can plan the treatment together. It might involve something as simple as ibuprofen or it could require surgery of some type.

ACTION YOU CAN TAKE
If you have continuing pelvic pain, see your Gynecologist and explain your symptoms. Many women wait too long to see their physician, only making the pain last longer and possibly worsen over time. Women should be encouraged not to suffer with pelvic pain. Most of the conditions causing female pelvic pain can be treated with significant improvement if not complete resolution of pain symptoms.

Find a Gynecologist near you.

Sources include: McLeod Health, American College of Obstetricians & Gynecologists, Prevention, National Institutes of Health, Johns Hopkins School of Medicine, National Association for Continence.