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What is Pelvic Pain?

Pelvic pain is defined as pain below the belly button within the pelvic region. While more prevalent in women, pelvic pain can also affect men. Pelvic pain can present as acute (a sudden, sharp pain due to an injury) or chronic (persistent or ongoing pain) and is difficult to properly diagnose given the wide range of bodily systems present within the pelvic region.

Pelvic pain can be attributed to the digestive tract, reproductive organs or the urinary system. It requires thorough examination and testing by a specialist to diagnose the underlying issue causing the pain.

What Causes Pelvic Pain?

There is a wide range of potential causes for pelvic pain in both men and women. It may be related to an issue in the pelvic bone, an infection of the colon, bladder or other non-reproductive organ, or it may be due to inflamed ligaments, tissues or nerves within the pelvic area.

Chronic pelvic pain, in which pain lasts more than six months, can be mild or severe, intermittent or longer lasting and may eventually interfere with one’s daily activities. It’s estimated that approximately 15 percent of women are affected by chronic pelvic pain with 4 percent experiencing severe pain affecting their ability to work.

For women, the most common causes of pelvic pain include:

  • Endometriosis – a disease in which tissue (the endometrium) that normally lines the inside of the uterus grows outside the uterus. Many women with endometriosis have pelvic or abdominal pain, particularly during menstrual bleeding or sex. Endometriosis can make it difficult to become pregnant. In fact, 30 to 50 percent of infertile women have endometriosis. Due to the tissue being hard to see on an ultrasound, the only certain way to detect endometriosis is through a surgical procedure called laparoscopy.
  • Ovarian Cysts – a fluid-filled sac that develops on an ovary and causes pelvic pain when it becomes twisted or bursts (it will probably need to be removed). In some cases the cyst can form from endometriosis (endometrioma) growing in an ovary, which can be seen on an ultrasound, unlike other forms of endometriosis.
  • Ovarian Cancer
  • Pelvic Inflammatory Disease – an infection of the female reproductive organs. It can lead to irreversible damage to the uterus, ovaries, fallopian tubes or other parts of the female reproductive system, and is the primary preventable cause of infertility in women. PID is one of the most serious side effects resulting from sexually transmitted diseases (STD), and 90 percent of the cases are a result of chlamydia and/or gonorrhea.
  • Uterine Fibroids – growths on the uterine wall and while not considered a problem, they can be painful
  • Vulvodynia – chronic vulvar pain without an identifiable cause, and the location, frequency and severity differs among patients. The most common symptom reported from patients suffering from this condition is a burning sensation.

For men, the following are the most likely causes of pelvic pain:

  • Prostatitis – when the prostate gland is inflamed, which is usually a result of an infection. It affects men of all ages, and it does not raise the risk of getting prostate cancer. Men suffering from this disorder usually have urologic problems such as burning or painful urination, the urgent need to urinate, trouble voiding, difficult or painful ejaculation, and pain in the area between the scrotum and rectum (known as the perineum) or lower back. The symptoms are similar to prostate cancer and benign prostatic hyperplasia (BPH), and they can occur at the same time but prostatitis is a separate condition. If someone has this condition for more than three months, he may be suffering from chronic prostatitis, which may be related to other urinary tract infections.
  • Prostadynia – is similar to prostatitis, but the pain is not a result of inflammation or an infection in the prostate gland. Medical experts in this field are not sure of the exact cause, but they think it might derive from stress or anxiety, which causes muscles to spasm.

Additional causes of pelvic pain in both men and women are:

  • Diverticulitis – is the inflammation or infection of pouches (diverticula) that form in the wall of the colon. Diverticulitis can be very painful, and usually causes bloating, diarrhea, constipation, nausea or fever. Doctors aren't sure of the exact causes for diverticula in the colon (diverticulosis), but they think that a low-fiber diet plays a role. Without fiber to add bulk to the stool, the colon has to work harder than normal to push the stool forward. The pressure from this may cause pouches to form in weak spots along the colon.
  • Interstitial Cystitis (Painful Bladder Syndrome) – is a chronic condition that occurs when the bladder muscles and nerves that normally create the urge to urinate get mixed up, causing the need to urinate more often with smaller volumes. You may experience bladder pressure, bladder pain and sometimes pelvic pain, ranging from mild discomfort to severe pain.
  • Kidney Stones> – are a hard crystalline mineral material formed within the kidney or urinary tract. They generally form when there is a decrease in urine volume and/or an excess of stone-forming substances in the urine. Kidney stones can be very painful and often cause blood in the urine.
  • Urinary Tract Infection (UTI) – is an infection in any part of the urinary tract. Most UTIs occur in the lower urinary tract, which includes the urethra and bladder. Women are more likely to have a UTI because their urethra is shorter, meaning bacteria doesn’t have to travel as far to reach the bladder. The spreading of infection to the kidneys can be a life-threatening condition. If you have more than two UTIs in a six-month period and/or three in one year, you likely have a pelvic floor disorder and if not treated you will continue to have UTIs.

Other Causes of Pelvic Pain for Both Men and Women include:

  • Fibromyalgia
  • Chronic constipation
  • Crohn’s Disease
  • Irritable Bowel Syndrome
  • Inguinal hernia
  • Intestinal obstruction
  • Appendicitis
  • Ulcerative Colitis

What Are the Treatment Options for Pelvic Pain?

Pelvic pain can be successfully treated with non-surgical options such as medication; however, it’s important to note that if the underlying cause of the pain resides in the organs of the pelvis, surgery may be the only viable option. The good news is that most surgical techniques for pelvic pain are minimally invasive, causing less pain and can result in faster recovery times.