Pelvic pain, between the hips and the navel, is a common complaint and will affect every woman from time to time in their lives. It can be extremely distressing for the sufferer and her family and is said to be chronic if it lasts for longer than six months.
Many organs belonging to different systems, which have a common nerve supply, populate the lower abdomen and pelvis. For this reason the source of pain is not always easy to identify. A detailed history followed by examination may give clues to the cause but often specialist investigation including swabs, scans, x-rays may be required. In some circumstances the doctor may recommend more invasive procedures such as laparoscopy or laparatomy in order to further investigate or treat the cause.
The pain may vary with the menstrual cycle, sexual intercourse, stress, bowel habit or have no pattern to it. There may also be other associated symptoms such as a discharge or diarrhoea.
The common causes include:
- Urinary tract infections; stones; tumours;
- Bowel causes such as constipation, irritable bowel syndrome, inflammatory bowel disease
- Gynaecology causes such as painful periods, which themselves can be a symptom; pelvic inflammatory disease; ovarian cysts; fibroids; pregnancy related - miscarriage and ectopic; endometriosis
- Pain arising from the back and hips can also be felt in the pelvic areaManagement should be directed to the cause and may sometimes require input from a gynaecologist, kidney and bladder specialist, a bowel specialist and an anaesthetist specialising in pain.