Gynecologic Health — Pelvic Pain

Nearly all women experience pain in their pelvis at multiple points in their lives. It is estimated that more than 15% of women experience chronic pelvic pain, defined as lasting more than 6 months. Pain is disabling if it affects your usual activities.

Some of the more common gynecologic causes of pelvic pain

  • Dysmenorrhea (pain during your period/menses) has multiple causes and is the most common cause of pelvic pain. Primary dysmenorrhea is now thought to be caused by the uterus cramping so hard to expel the menses that the uterine muscle doesn't get any oxygen and becomes ischemic (losing its blood supply), like the heart during a heart attack. Anything that causes heavy bleeding often requires the uterus to cramp more to expel the blood and thus cause dysmenorrhea. Endometriosis usually, but not always, causes dysmenorrhea. Adenomyosis, endometriosis within the muscle of the uterus, is also notoriously painful.

  • Endometriosis can also cause pain, injury to the fallopian tubes, and infertility. The endometrium is the lining of the uterus. Endometriosis is defined as endometrial tissue located anywhere it isn't supposed to be. Like the endometrium, endometriosis grows and then sheds/bleeds every month during menstruation. That bleeding is irritating to other tissue and causes pain.

  • Pelvic inflammatory disease (PID) is an infection in the uterus and fallopian tubes, most commonly caused by a sexually transmitted infection (STI). PID is usually but not always painful. Early prompt treatment can prevent injury to the fallopian tubes. If the fallopian tubes are injured, infertility and ectopic pregnancy can result.

  • Ectopic pregnancy is a pregnancy located outside the body of the uterus. It can be life threatening and requires emergency treatment because it can rupture and bleed, often before a woman knows she is pregnant. Despite modern medicine, 4% to 10% of all pregnancy-related deaths are attributed to ectopic pregnancies. Please take a pregnancy test if you have a new pain in your pelvis and there is any chance that you are pregnant. Remember: contraception can fail.

There are many other gynecologic causes of pain in the pelvic region. Yet not all causes of pelvic pain are gynecologic. The urinary, bowel, and musculoskeletal systems can also cause pain. In addition, individual interpretations of pain are changed by the social and emotional contexts in which they occur, for example, if someone has a history of sexual or physical abuse.

At Women's Health Consultants we are specially trained to help you determine the cause of your pelvic pain and the optimal treatment(s) for you.