Shedding Light on Pelvic Pains: Causes

Pain is an unpleasant bodily ache experienced as a result of derangement of functions, disease or injury. They come in a myriad of types. Pain in the abdomen is an example; to be specific, pelvic pain.

The lowest part of your tummy (abdomen), is the pelvis. It contains organs like the bowel, bladder, womb (uterus) and ovaries. When we talk of pelvic pain, we refer to the sufferings that start from one of these organs. However, other times the pain originates from the bones that lie next to these organs, or from nearby muscles, nerves, blood vessels or joints. Pelvic pain is more common in women than in men.

There are many causes of pelvic pains, whether acute or chronic. Acute means that you’re experiencing them for the first time. Chronic means that pain has been a problem for a long time – more than six months. Several underlying problems are associated with various conditions. Among them are the problems associated with pregnancy like miscarriage, ectopic pregnancies and premature labor among others.

Miscarriage is the loss of a pregnancy at any time up to the 24th week. Normally, 7 or 8 miscarriages out of 10 occur before 13 weeks of pregnancy. Vaginal bleeding and abdominal cramps are but the usual symptoms. It often is followed by the passage of some tissue from the vagina, which often looks like a blood clot.

Ectopic pregnancies is another cause of pelvic pains. An ectopic pregnancy is one that tries to develop outside the womb (uterus). It’s occurrence is about 1 in 100. Usual symptoms include pain on one side of the lower abdomen or pelvis. It tends to develop sharply, or may slowly become worse over several days. It can become severe. Vaginal bleeding often occurs, but not always. It is often darker-coloured than the bleeding of a period.

When the corpus luteum cyst, the one that makes hormones that help keep you pregnant, until other organs such as the placenta take over, ruptures it causes tummy pains. A corpus luteum forms after the release of the egg at ovulation. They are often found, by chance, when you have an ultrasound scan for whatever reason. They often cause no problems at all and clear up without treatment. Sometimes it can become too swollen and may burst. This may cause sharp pain on one side of your pelvis. If you have pain in your pelvis in the first 12 weeks of your pregnancy, see your doctor.

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Labor that normally labor starts after 37 completed weeks of pregnancy (premature labor) is another problem associated with pelvic pains. Normal labor usually starts as tightening felt across the lower abdomen. They then get stronger, more aching and are frequent each other. A gush of fluid from the vagina that is normally experienced means that your waters may have broken. You should contact your midwife immediately. If you have pelvic pains that come and go in a regular pattern, contact your midwife for advice.

Rarely in about 6 out of 1,000 deliveries, the placenta detaches from the wall of the womb. Before 24 weeks of pregnancy this is a miscarriage; however, after 24 weeks it is called an abruption. This is an emergency. The why is because the baby relies on the placenta for food and oxygen. An abruption therefore would starve the baby and will die. This is the reason why the baby is quickly delivered by the emergency caesarean section.

Pregnancy issues are not the only causes of pelvic pains. Some are caused by gynecological problems. During ovulation some women develop a sharp pain when an egg is released. This is called ‘Mittelschmerz’ (middle pain – because it occurs mid-cycle). Every month, the pain may be on a different side as it is dependent on which ovary releases the egg. However, this pain only lasts for some time but some women find it is severe.

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Menstrual cramps (dysmenorrhea) is another cause of pelvic pains. As it happens, the pain is often mild but, in about 1 in 10 women, the pain is overwhelming enough to affect day-to-day activities. It can be so severe that they are unable to go to school or work. Pelvic inflammatory disease (PID) is an infection of your womb. Germs (bacteria) that cause the infection usually travel into your womb from your vagina or cervix. Most cases are caused by chlamydia or gonorrhea. Symptoms of PID include pain in your lower abdomen or pelvis, high temperature (fever), abnormal vaginal bleeding and a vaginal discharge. It often is another reason for many abdominal pains.

There is a fluid-filled sac which develops in an ovary called the ovarian cyst. Most are non-cancerous (benign) and cause no symptoms. On the other hand, some cause problems such as pain and irregular bleeding. When they burst or twist (called torsion) they cause unbearable pain. No treatment may be needed for certain types of ovarian cysts which tend to go away on their own.

Incoherent changes in a fibroid is among the causes of tummy pains. Fibroids are common and usually cause no symptoms. However, they can sometimes cause heavy periods, abdominal swelling and urinary problems. Hardly do they outgrow their blood supply. This can make them shrink (degenerate) which can be very painful. Endometriosis : this is a condition found in women between the ages of 13 and 50. It is most commonly diagnosed in women in their thirties. It is more common in women who are having trouble conceiving. In these women it can be found in 1 out of 5 of them. It causes pain around the time of your period. It may also cause pain when you have sex.

In chronic pelvic pains, a cause sometimes is found (such as those above) and in some cases, there is no obvious cause. If the source of your chronic pelvic pain can be found, treatment focuses on that cause.

Some women never receive a specific diagnosis that explains their pain. In such a case, treatment for managing the pain is recommended as is keeping a symptoms diary so as to identify what really triggered the pains. Depression, chronic stress or a past history of sexual or physical abuse increases your risk of developing chronic pelvic pain. In addition, any emotional distress often makes pain worse and living with chronic pain contributes to emotional distress. Your doctor will often consider psychological treatments to help with the pain.