Causes of Pelvic Pain
When considering a long list of possibilities, make sure to remember this famous diagnostic principle :
HORSES ARE MORE COMMON THAN ZEBRAS.
- Non reproductive organ disease is an important cause of pelvic pain. Examples would be disease of bowels, urinary tract or the pelvis itself.
- Normal processes may cause pain, i.e., pregnancy, ovulation.
- Abnormal pregnancy like miscarriage or ectopic pregnancy can cause pain.
- Infections of pelvic organs with or without abscess cause pain.
- Hernias in various places may cause pain.
- Cysts of the ovaries or fallopian tubes may cause pain by causing pressure, twisting or rupturing.
- Fibroids (aka myomas) in the uterus may cause pain.
- Endometriosis may cause pain. ( Click HERE to learn more.)
- Adhesions, aka scar tissue, may cause pain.
- Pelvic floor muscle problems may cause pelvic pain.
- Nerve irritability or damage from any of the above.
What is the workup of pelvic pain ?
All workups should start with a history and a physical. When patients visit the doctor for conditions such as pelvic pain that are not straightforward, they should be prepared to answer a number of detailed questions about the pain.
Then comes the physical exam, and finally lab and imaging studies. These are requested in an order that makes the most sense for the individual patient but can include:
Bloodwork: pregnancy tests, blood counts, chemistries
Noninvasive imaging: Ultrasound, CT scan, MRI scan
Invasive imaging: Laparoscopy, Colonoscopy, Cystoscopy.
Patients should not be surprised if it takes a multistep process to learn about the cause or causes of pelvic pain.
Is there a treatment for pelvic pain?
Click on the mad scientist's laboratory to learn more.