Pelvic pain
Pelvic pain and lower abdominal pain are very common in women. They are associated with gynecological events such as ovulation and menstruation. However, the causes of pain are often non-gynecological and can be attributed to urinary tract issues, intestinal problems, musculoskeletal system, spine conditions, and other causes.
Based on onset and duration, pain can be acute (sudden onset) or chronic (present for 6 months or more), it can be cyclical and occur monthly (most commonly of gynecological origin) or more persistent and doesn’t significantly change during the cycle (often due to lumbar spine changes and hypertonic pelvic floor muscles).
In gynecological causes, pain can occur due to cyst wall stretching (distension), cyst rupture, or ectopic pregnancy rupture.
Pain can also be caused by major bleeding and subsequent hematoma formation in the pelvis, or due to interrupted blood supply to the ovary during torsion (ischemia). Pain may also result from ovarian inflammation (adnexitis) or pelvic endometriosis.
Clinical examination and precise ultrasound diagnostics are very important in diagnosis, sometimes supplemented by laboratory tests (complete blood count, CRP, CA 125).
Treatment
Treatment depends on the cause of pain; for mild pain, analgesic therapy alone (NSAIDs) is sufficient, and sometimes hormonal therapy (including contraceptive pills) is prescribed.
For more severe pain, diagnostic laparoscopy may be recommended, which both confirms and removes the cause of pain.
