Pelvic pain is a common symptom experienced by prepubertal and adolescent girls. When girls experience pain, it is important to note the location of the pain, timing, any inciting events, and things that alleviate the pain or exacerbate the pain response. It can be a difficult, partly due to the fact that many organs in the pelvic region are in close proximity to one another. In addition, these organs frequently share a similar nerve supply; therefore, specifically localizing the pain to a certain area can be difficult. Acute pain may result from trauma, new exercise activities, ovulation, infection (ie., appendicitis or bladder infection) or adnexal problems, such as ovarian torsion or ruptured ovarian cyst. This type of pain usually is sudden in onset, but factors which alleviate the pain may be different. For instance, acute pain resulting from injury may improve with over-the-counter, non-steroidal, anti-inflammatory agents, whereas acute pain resulting from a twisted ovary will not improve with any pain medications, but rather requires surgical intervention for pain relief. Common reasons why young girls experience chronic pain include both gynecologic and non-gynecologic reasons. Gynecologic causes may be related to menstrual cramps, onset of endometriosis, prior history of surgery with adhesive disease or prior history of pelvic inflammatory disease, to name a few. Non-gynecologic causes may be related to chronic bladder spasms, constipation or even musculoskeletal pain (a cause of pain in 30-50% of cases). When pain occurs acutely or chronic pelvic pain persists, and does not improve with over-the-counter measures, an evaluation by your provider is necessary. Please contact the Pediatric and Adolescent Gynecology Clinic for additional information.
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