What is pelvic pain?
Pain is very subjective , every individual perceives pain differently. With this in mind, chronic pelvic pain is presence of dull aching or stabbing pain below the umbilicus for at least six months.
What causes pelvic pain?
Endometriosis is the most common cause of cyclical pain in reproductive age group women. Pelvic inflammatory disease causes pelvic pain by infection entering into the abdomen (from vagina via fallopian tubes).
Most common cause of pain with an ultra sound finding of a “bulky” uterus is adenomyosis. This condition causes heavy bleeding associated with pain during menstruation.
Acute pain can be caused due to fibroid degeneration or fibroid twisting its pedicle. Large fibroids can cause pain due to the pressure they exert inside the abdomen(to neighbouring organs).
Ectopic pregnancy where pregnancy occurs outside the uterine cavity (commonly within the fallopian tubes) can cause acute pelvic pain because of sudden rupture of the fallopian tube. Thus its prudent that all women who present with acute pelvic pain (in reproductive age group) must undergo a pregnancy test.
What investigations can help diagnose pain?
Ultrasound is a cheap and fantastic tool to identify various pathologies responsible for pain. In some cases a CT or MRI may be warranted for additional diagnostic insights.
This did not diagnose my abdominal pain. What next?
In situations where non-invasive investigations fail at a diagnosis, A hystero- laparoscopy will definitely give a diagnosis in most situations.
What is the management of pain abdomen ?
Once a diagnosis is made , then treatment would be started according to the cause. For a complete list of all the causes have a look here.