Abdominal Cramping - Pelvic Pain in Females
Overview, Causes, & Risk Factors
A woman's pelvis
contains the uterus, fallopian tubes, ovaries, vagina, bladder, and rectum.
Pelvic pain refers to any pain or discomfort in this area of the body.
What is going on in the body?
Pelvic pain is a common symptom in
women. It is frequently, but not always, related to the reproductive system.
Other causes of pelvic pain are related to the intestines or urinary tract.
Psychological factors can make the pain seem worse, or even cause a sensation
of pain where no physical problem exists.
Pelvic pain can range from mild discomfort or cramping, to severe, intense
pain. This pain may be acute, when it occurs suddenly, or chronic, when the
pain lasts for a long period of time.
What are the causes and risks of the condition?
Pelvic pain in
females has many causes including:
pelvic adhesions, which are fibrous bands holding parts together that are usually separate
endometriosis, a disorder in which patches of endometrial tissue (normally found only in the lining of the uterus) grow outside the uterus
peritonitis, an inflammation usually caused by an infection of the lining of the abdomen
urinary tract infection
hernia, or a bulging of
internal organs or tissues through an abnormal opening in the muscle wall
Mittelschmerz, which is pain in the middle of the menstrual cycle caused by ovulation
ectopic pregnancy, a pregnancy in which the fetus develops outside of the uterus
uterine fibroid, a
noncancerous growth that occurs in the wall of the uterus
colon cancer or ovarian cancer
diverticulosis, a saclike
protrusion of any part of the digestive tract, usually in the large
irritable bowel syndrome
gastroenteritis, a general
term for a group of conditions caused by infection in the digestive tract
abscess, or an accumulation of pus usually caused by a bacterial
pelvic inflammatory disease (PID), an infection of the uterus, fallopian tubes, and adjacent pelvic structures. PID is commonly caused by a sexually transmitted disease that is not treated quickly and effectively.
appendicitis, or inflammation of the appendix
musculoskeletal disorders, such as a misalignment or shifting of the pelvic bones
psychological factors, such as
Other causes are also possible. In some cases, the cause is never found.
Symptoms & Signs
What are the signs and symptoms of the condition?
woman has pelvic pain, the healthcare provider will want more information.
Questions may be asked about the pain, including:
When did the pain start?
How long has the pain existed? When does it stop? How often does it occur?
What type of pain is it? Dull, sharp, steady, or crampy?
Where is the pain located?
When was the last menstrual
period? Was it a normal period?
Is there any vaginal bleeding or drainage?
Does anything decrease the pain or make the pain worse?
Are there any other symptoms, such as fever, fatigue, malaise, nausea, vomiting, change in bowel movements, or trouble urinating?
Is the woman sexually active? Does she use protection?
What medications, drugs, or herbs does the person take, if any?
Is there a history of any other medical problems or surgery?
Other questions may also be asked in some cases.
Diagnosis & Tests
How is the condition diagnosed?
Diagnosis of pelvic pain
begins with a history and physical exam. The healthcare provider may order
a urinalysis and a urine culture to rule out any kidney or bladder disorders, such as an infection or kidney stones
blood tests, which may include a complete blood count or CBC, to check for infection
a pregnancy test
a pelvic exam to help determine which organs are affected and whether an infection is present
other types of x-ray tests, such as ultrasound, CT scans, or MRI scans
Prevention & Expectations
What can be done to prevent the condition?
pelvic pain may or may not be possible, depending on the cause. Some ways to
decrease the risk of pelvic pain include:
practicing safer sex to decrease the risk of
sexually transmitted disease and secondary PID
seeking early treatment for infections of the genital tract, such as PID
oral contraceptives, which may reduce the risk of pelvic pain associated with painful ovulation
drinking plenty of fluids every day and avoiding dehydration to prevent kidney stones
Many of the causes of pelvic pain cannot be prevented.
What are the long-term effects of the condition?
are related to the cause of the pelvic pain. For example, irritable bowel syndrome may make a person uncomfortable and even depressed, but poses no serious long-term health risks. A small kidney stone may pass by itself and have no long-term effects. A large kidney stone may require surgery to remove. Cancer may lead to death if treatment is unsuccessful. A woman with an
ectopic pregnancy may need
surgery, and in some cases, may have to have the fallopian tube removed.
What are the risks to others?
Pelvic pain itself is not
contagious and poses no risk to others. However, if the pain is caused by a
sexually transmitted disease, that infection is contagious.
Treatment & Monitoring
What are the treatments for the condition?
Specific treatment for pelvic
pain depends on the cause of the pain. Treatment may include:
nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or
oral contraceptives to stop pain caused by ovulation
What are the side effects of the treatments?
Side effects to treatment will depend on the treatment used. There may be stomach upset, diarrhea, or allergic
reaction to antibiotics. There may be stomach upset, ulcers and
bleeding, or allergic reaction to NSAIDs. NSAIDs may also affect the liver and kidneys. Treatments that require surgery pose a risk of bleeding, infection, and allergic reaction to anesthesia.
What happens after treatment for the condition?
What happens after treatment depends on the success of the treatment and the cause of the pain. For example, those who pass a kidney stone on their own or have it removed may not need any further treatment. Those with cancer may need long-term treatment for the cancer and may die if treatment is unsuccessful.
How is the condition monitored?
Any new or worsening
symptoms should be reported to the healthcare provider.
Author:Gail Hendrickson, RN, BS
Editor:Smith, Mary Ellen, BS
Reviewer:Eileen McLaughlin, RN, BSN
Harrison's Principles of Internal Medicine, 1998, Fauci et al.
The Merck Manual of Medical Information, 1997
Professional Guide to Diseases: 6th edition, 1998