In-Office Evaluation — Pelvic Pain

Pelvic pain is a general term used to describe pain that occurs mostly in the lower-abdomen area. The pain may be acute (sudden in onset) or chronic (lasting more than 6 months). Pelvic pain is initially evaluated in the clinic. We assess the history of symptoms and perform a careful physical examination.

Pelvic pain is commonly caused by dysfunction in the female genital organs; however, it can also be caused by diseases of the lower intestines or urinary tract. Sometimes, pelvic pain can be caused by muscular or skeletal problems.

What conditions cause pelvic pain?

There are several causes of pelvic pain, and symptoms often differ by diagnosis. Here are the most common health conditions that are often associated with pelvic pain: 

  • Dysmenorrhea: pain during the menstrual period
  • Endometriosis: pain caused by inflammation and uterine tissue that is growing outside the uterus
  • Pelvic inflammatory disease (PID): pain caused by an infection of the uterus and/or fallopian tubes
  • Ovarian cyst: when the ovary produces a large, painful cyst, which may rupture
  • Ovarian torsion: when the ovary is twisted in a way that interferes with its blood supply
  • Ectopic pregnancy: a pregnancy implanted outside the uterus, often within the fallopian tube
  • Vulvodynia: pain in the vulva or external genital area
  • Uterine fibroids: noncancerous tumors that grow within and around the wall of the uterus
  • Pelvic joint instability: pain caused by misaligned pelvic joints or abnormal stretching of pelvic ligaments

What is the treatment for pelvic pain?

Treatment for pelvic pain depends on the exact cause as well as the duration and severity of the pain. Your evaluation will include a thorough history and physical exam. Additional testing may include blood and urine tests, pelvic ultrasound, or other imaging such as CT or MRI, screenings for STDs or other infections, and sometimes surgical evaluation.

Mild pelvic pain can often be treated with over-the-counter medications such as Tylenol or Ibuprofen. Other medical treatments include:

  • Prescription pain medications or anti-inflammatory medications
  • Antibiotic pills or creams
  • Hormone pills or creams
  • Surgery
  • Physical therapy
  • Complementary treatments such as acupuncture, relaxation, biofeedback