Less serious causes of pelvic pain are usually of a short duration. However, the pain can be very strong, for example, with dysmenorrhea - a painful condition that occurs with spasms of the uterus during menstruation. Other more serious and common causes of chronic and severe pelvic pain are pelvic inflammatory disease, ectopic pregnancy and endometriosis.
Other causes of pain
Pathology of the anus and rectum can also be the cause of pelvic pain and is usually felt in the lower back. In more rare cases, pelvic pain can occur with diseases such as uterine myoma, appendicitis, intestinal or bladder problems, and cancers of the pelvic organs. If the pain does not stop for a long time, you need to see a doctor. Inflammatory pelvic diseases (PID) include inflammation of the uterus, fallopian tubes and ovaries as a result of infection. The most common cause of these diseases is chlamydia, a sexually transmitted infection that occurs in 50-80% of cases of PID. Other likely causative factors include gonorrhea and anaerobic infections. PID can occur either spontaneously or as a result of surgical intervention in the pelvic area or after the introduction of an intrauterine device (IUD). In the latter case, the disease occurs more often in the presence of undiagnosed chlamydial infection.
Symptoms
The pain usually lasts for several hours, is localized in the lower abdominal and suprapubic regions and is blunt, aching. Sometimes it can be very intense and intensify during intercourse. Pains tend to appear with sudden movements and decrease if the woman lies or sits quietly. Other symptoms include pain during urination and fever. Sometimes the pain is so severe that the woman is unable to move and feels nauseous, but such cases are relatively rare; more often the pain is mild.
Diagnostics
Since there is no specific analysis confirming the woman's PID, the diagnosis is based on the results of a comprehensive survey. Of particular diagnostic value are such symptoms as soreness of the cervix and vaginal vaults (tissue gut around the cervix) with vaginal examination.
Treatment
In severe cases, treatment in a hospital setting with antibiotics administered intravenously is required. In other cases, treatment is done out-patient, with antibiotics administered inside. Most women with suspected PID should pass the test for chlamydia, and ideally - to undergo examination in a specialized urogenital clinic. In such clinics, doctors will be offered not only to be screened for chlamydia, but also if necessary to undergo antibiotic treatment before the end of pregnancy or the introduction of the IUD. Ectopic pregnancy determines the condition in which a fertilized egg develops outside the uterus, most often in the fallopian tube. This can occur due to scarring of the fallopian tubes, which often develops as a result of a chlamydial infection. After 2-4 weeks after fertilization of the ovum, the uterine tube may break, accompanied by sharp pain and bleeding.
Symptoms
The pain usually occurs suddenly and is localized in the lower abdomen, right or left. The pain can be so strong that a woman can not even walk. However, sometimes the symptoms can be so unintelligible that it deceives both the doctor and the woman who can not say exactly what is bothering her. If there is intense internal bleeding, the patient looks pale, feels weak and dizzy and can faint when trying to stand up. As a rule, the conversation reveals that the woman has a delay or abnormal character of menstruation, in addition, she can feel the subjective signs of an early pregnancy. However, sometimes an ectopic pregnancy can manifest itself before the term of another menstruation.
Diagnostics
When a vaginal examination, the doctor usually finds pain in the arches of the vagina (the vaginal area surrounding the cervix) on the side where the patient feels pain. Another symptom may be an increase in the size of the fallopian tube, which can be confirmed by ultrasound. The pregnancy test is usually positive.
Treatment
Ectopic pregnancy requires emergency measures, because it is a potentially life-threatening condition. In most cases, an open surgery or laparoscopy is performed. In rare cases, treatment is limited to the injection of the drug methotrexate.