| Pelvic pain | |
|---|---|
 | |
| Female type pelvis | |
| Specialty | Gynecology |
| Types | Acute, chronic[1] |
| Diagnostic method | History of symptoms, physical examination, laboratory testing, medical imaging[2] |
| Differential diagnosis | Female: Menstrual cramps, endometriosis, ectopic pregnancy, pelvic inflammatory disease, ovarian torsion[3][4][2] Gastrointestinal: Appendicitis, irritable bowel syndrome, gastroenteritis, constipation[4][5][2] Urinary: Bladder infection, kidney stone, interstitial cystitis[4] Other: Fibromyalgia, abdominal wall muscle injury, abdominal aortic aneurysm[4] |
| Frequency | Common[5] |
Pelvic pain is pain between the region of the hips.[4] The pain can be acute, meaning it is is of sudden onset, or chronic, meaning it remains present either intermittently or continuously for a prolonged period of time.[1] If the pain lasts for less than 3 month it is generally classified as acute;[2] while if it last more than six months it is generally classified as chronic.[5] Depression may worsen symptoms.[4] It is separate from perineal pain.[3]
Causes of pelvic pain may relate to the female reproductive organs, the gastrointestinal or urinary tract, or structures near the pelvis such as the lower aspect of the aorta.[4] Common causes related to the female reproductive organs include menstrual cramps, endometriosis, and fibroids; while serious causes include ectopic pregnancy, pelvic inflammatory disease, and ovarian torsion.[3][4][2] Common causes related to the gastrointestinal tract include irritable bowel syndrome, gastroenteritis, constipation, and colon cancer.[4][5] Other serious causes include appendicitis.[2] Common causes related to the urinary tract include bladder infections, kidney stones, and interstitial cystitis.[4] Other causes include fibromyalgia, abdominal wall muscle injury, and abdominal aortic aneurysm.[4] Chronic pain may also occur following sexual abuse.[4]
Diagnostic work up includes the history of symptoms and physical examination and may be supported by laboratory testing and medical imaging.[2] A pregnancy test is recommended in all women who could potentially be pregnant.[2] Worrisome findings include fever, vaginal bleeding after menopause, low blood pressure, and peritonitis.[3]
Pelvic pain can affect both women and men though chronic pelvic pain most commonly affects women.[5] About 2% to 24% of women have pelvic pain unrelated to their menstural cycle, 8% to 21% have pain with sex, and 17% to 81% have pain with their periods.[5] Chronic pelvic pain occurs in at least 6 to 27% of women.[5]