Pelvic Pain

Pelvic pain is pain in the lower abdomen. It is one of the most common complaints among girls as they enter puberty, and one of the most frequent causes of doctor visits.

Pelvic pain may be:

• Acute – Pain that begins suddenly and may be sharp in intensity
• Chronic – Pain that has lasted for several months

Patients can be seen by Texas Children's experts in Pediatric and Adolescent Gynecology.

Causes & Risk Factors

Pelvic pain is typically caused by problems with a girl’s reproductive system or urinary system.

Common gynecologic causes include:

• Pelvic inflammatory disease – infection of the female reproductive organs
• Ovarian cysts
• Endometriosis – pain caused by uterine tissue found elsewhere in the body
• Dysmenorrhea – menstrual cramps
• Mittelschmerz – ovulation pain
• Ovarian torsion – a condition in which the ovary is twisted
• Uterine fibroids
• Ectopic pregnancy – a pregnancy outside the uterus
• Abnormalities of the female reproductive tract

Symptoms & Types

Pelvic pain varies depending on the cause.

It can range from mild to severe, from a dull, annoying ache to a sharp pain or cramping that interferes with normal activities.

The pain may be constant, or it may come and go. In some cases it can spread down to the legs or lower back.

In other cases it may feel more like pressure or heaviness in the abdomen.

Sometimes pelvic pain is associated with specific activities, such as sitting down, urinating, having a bowel movement, or sexual intercourse.

Diagnosis & Tests

The cause of pelvic pain can be difficult to determine.

Diagnosis starts with a detailed medical history and discussion of symptoms, including when the pain began, menstrual cycle dates, the location, severity and frequency of the pain, and other symptoms.

A physical exam, including a thorough abdominal exam, will also be conducted.

Diagnosis may also include:

• A pelvic exam
• Blood test
• Urine test
• Pregnancy test, if sexually active
• STD testing, if sexually active
• Imaging – such as an ultrasound, X-ray or CT scan to examine the pelvic organs
• Laparoscopy – uses a thin, lighted tube with a camera on the end (laparoscope) inserted through a small incision to view inside the abdomen

Treatment & Care

Treatment depends on the individual and the underlying cause of the pelvic pain.

Treatment strategies include:

• Pain relief medication – prescription or over-the-counter
• Hormone treatments – to help relieve pelvic pain related to the menstrual cycle
• Antibiotics – to address any underlying infection
• Physical therapy – including applying heat and cold to the abdomen, stretching exercises, massage and other relaxation techniques
• Transcutaneous electrical nerve stimulation (TENS) – delivers electrical impulses to nerve pathways to relieve pain
• Trigger point injections – long-lasting numbing medicine injected into painful spots to block pain
• Surgery – to correct an underlying problem, including laparoscopic surgery for treatment of endometriosis
• Stress management techniques – such as meditation or deep breathing
• Alternative therapies – including biofeedback and acupuncture