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Pelvic pain is a common complaint among women and can be caused by a number of pelvic conditions. Its nature and intensity may fluctuate, and its cause is often obscure. In some cases, no disease is evident.
Pelvic pain can be categorized as either acute, meaning the pain is sudden and severe, or chronic, lasting over a period of months or longer. Pelvic pain may originate in genital or extragenital organs in and around the pelvis, or it may be psychological, which can make pain feel worse or actually cause a sensation of pain when no physical problem is present.
The following are examples of the different types of pelvic pain most commonly described by women and their possible cause or origin. Always consult your physician for a diagnosis.
The pelvis is a complex region that houses many important structures including the bladder, urethra, uterus, ovaries, vagina, bowel and a complex muscular support structure. Dysfunction in any of these areas may contribute to pain in the pelvis. In women, common nerves innervate these regions and inflammation or irritation of one stucture can flare other surrounding structures. Although pelvic pain is common in women, it is also found frequently in men. Men and women both share supportive pelvic floor muscles and spasm or inflammation of these muscles are a frequent cause of pelvic pain and urinary and bowel dysfunction.
Pelvic pain may have multiple causes, including:
Some of the more common sources of acute pelvic pain, or pain that occurs very suddenly, may include:
Some of the conditions that can lead to chronic pelvic pain, pain that may last for several months or longer, may include:
This long-term and often unrelenting pain may cause a woman's defenses to break down, resulting in emotional and behavioral changes. This occurrence is often termed "chronic pelvic pain syndrome."
Diagnostic procedures and tests will be performed in order to determine the cause of the pelvic pain. In addition, your physician may ask you questions regarding the pain such as:
Additional information about the timing of the pain and the presence of other symptoms related to activities such as eating, sleeping, sexual activity and movement can also help the physician in determining a diagnosis.
In addition to a complete medical history and physical and pelvic examination, diagnostic procedures for pelvic pain may include:
Treatment for pelvic pain can range from behavioral therapies, medication or surgery. Based on your diagnosis, your doctor may recommend one of the following treatments for pelvic pain:
Specific treatment for pelvic pain will also be determined based on:
If a physical cause for your pelvic pain cannot be found, it may be diagnosed as a psychological defense or coping mechanism for some type of trauma. In some cases, psychotherapy is recommended. In other cases, physicians may recommend a multi-disciplinary treatment utilizing a number of different approaches including nutritional modifications, environmental changes, physical therapy and pain management.
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