Pelvic pain is a common and sometimes confusing symptom that affects as many as 1 in every 7 women according to the National Institutes of Health. At Summit Health, our gynecologists want you to know that you do not have to tolerate this type of discomfort. If you are experiencing pain, they encourage you to make an appointment with your doctor for an evaluation.
Danielle Calvo, MD, and Mary McGue, MD, specialists in obstetrics and gynecology, answer frequently asked questions about pelvic pain. Learn about the types of symptoms women experience, why pelvic pain can be tricky to diagnose and how you can find a treatment to improve your quality of life.
Q. What are the symptoms of pelvic pain?
Dr. Calvo: Everyone experiences pelvic pain differently. My patients often describe the following symptoms: a sharp or stabbing pain in the lower abdomen or a dull, constant ache. They also commonly tell me that the pain is associated with their menstrual cycles or occurs during intercourse, urination or bowel movements.
Q. Why can pelvic pain be difficult to diagnose?
Dr. McGue: Pelvic pain has many possible causes that are not just limited to gynecologic origins. What a patient describes as pelvic pain can often be attributed to other organ systems such as gastrointestinal issues (irritable bowel disease, constipation or appendicitis), urologic issues (cystitis, pyelonephritis or kidney stones) or musculoskeletal issues (hernia or muscular pain). When the pain has a gynecological origin, it may be from menstrual cramps or other conditions such as endometriosis, ovarian cysts, urinary tract infections, fibroids or pelvic inflammatory disease.
Q. Pelvic pain can be hard to diagnose. How do you begin to identify the cause?
Dr. Calvo: When I see a patient complaining of pelvic pain, the most important part of my evaluation is the history and physical exam. This gives me insight into what steps are best to take next.
If I suspect there is a structural cause of the pain, a pelvic ultrasound is generally the best test to assess the female reproductive organs. Structural issues of the female reproductive system include fibroids, ovarian cysts or uterine polyps.
Q. What is your advice to women who are experiencing pain? How long should they wait before seeing a physician?
Dr. McGue: If a woman is experiencing pain, it is important to know where the patient is in their menstrual cycle, what they were doing when the pain started, and how long the pain has been going on.
Acute pain means it has been less than seven days since the pain started, while chronic pain has lasted for more than six months.
We often recommend a trial of over-the-counter pain relievers like acetaminophen or ibuprofen as this helps us to determine if the patient should be seen in the office or the emergency room. If over-the-counter medications help with the pain, a woman should make an appointment to see their gynecologist. If the pain is not relieved by medication or is associated with loss of appetite, nausea and vomiting, it's important to call your doctor to determine if you should go to the emergency room and be seen immediately.
Q. How is pelvic pain treated?
Dr. Calvo: Depending on the cause of the pelvic pain, there are many treatment options available. If the pain is related to the menstrual cycle, hormonal interventions like the birth control pill can help. When the pain is related to a gynecological condition, I advise my patients to try alternatives to medication including pelvic floor therapy, acupuncture and neuromodulation which stimulates the nerves and can help interrupt the pain. When there is a structural cause such as a cyst or fibroid certain patients may benefit from surgical solution.
Q. Anything else you want women to know about pelvic pain?
Dr. McGue: Many menstruating women will report feeling ovulation pain, which occurs when an egg is released from the ovary midway through each menstrual cycle. This “crampy” pain can be localized to one side of the abdomen, lasts a couple of days each month and is not a cause for concern. Using an app to track your cycle can help pinpoint when the pain occurs and what treatment options may work.
How Summit Health can help
You do not have to suffer from pelvic pain. At Summit Health, our gynecologists are available to meet with you and develop a plan to determine what is causing your pelvic pain. Make an appointment for an evaluation today.