Female Pelvic Pain

• Localized pain
• May be due to inflammation
• Colicky pain
• May be caused by spasm in a soft organ, such as the intestine, ureter, or appendix
• Sudden onset of pain
• May be caused by a temporary deficiency of blood supply due to an obstruction in the circulation of blood
• Slowly-developing pain
• May be due to inflammation of the appendix or an intestinal obstruction
• Pain involving the entire abdomen
• May suggest an accumulation of blood, pus, or intestinal contents
• Pain aggravated by movement or during examination
• May be a result of irritation in the lining of the abdominal cavity

Pelvic pain may have multiple causes, including inflammation or direct irritation of nerves, muscular contractions or cramps of both smooth and skeletal muscles, and psychogenic factors, which can cause or aggravate pain. Pelvic pain causes include:

Acute Pelvic Pain:

• Ectopic pregnancy, a pregnancy that occurs outside the uterus
• Pelvic inflammatory disease (PID), an infection of the reproductive organs
• Twisted or ruptured ovarian cyst
• Miscarriage or threatened miscarriage
• Urinary tract infection
• Appendicitis
• Ruptured fallopian tube

Chronic Pelvic Pain:

• Menstrual cramps
• Endometriosis
• Uterine fibroids—abnormal growths on or in the uterine wall
• Adhesions—scar tissue between the internal organs in the pelvic cavity
• Endometrial polyps—protrusions attached by a small stem in the uterine cavity
• Cancers of the reproductive tract

Diagnostic procedures and tests will determine the cause of your pelvic pain. In addition to a complete medical history, your urologist will also complete a physical and pelvic examination. Diagnostic procedures may include:

• Blood tests
• Pregnancy test
• Urinalysis
• Culture of cells from the cervix
• Ultrasound, a diagnostic imaging technique that uses high-frequency sound waves to create an image of the internal organs.
• CT-scan, a noninvasive imaging procedure to detect abnormalities that may not show up on an X-ray.
• Magnetic Resonance Imaging (MRI), a noninvasive procedure that produces a two-dimensional view of an internal organ or structure.
• Laparoscopy, a minor surgical procedure in which a thin tube with a lens and a light is inserted into an incision in the abdominal wall to view the pelvic area.
• X-ray, electromagnetic energy produces images of bones and internal organs.
• Colonoscopy views the length of the large intestine, and can identify abnormal growths, inflamed tissue, ulcers, and bleeding.
• Sigmoidoscopy examines the inside of a portion of the large intestine, and is helpful in identifying the causes of diarrhea, abdominal pain, constipation, abnormal growths and bleeding.

Specific treatment for pelvic pain may include:

• Antibiotic medications
• Anti-inflammatory and/or pain medications
• Relaxation exercises
• Oral contraceptives (ovulation inhibitors)
• Surgery
• Physical therapy

If a physical cause cannot be found, pelvic pain may be diagnosed as a psychological defense or coping mechanism for some type of trauma. In some cases, psychotherapy is recommended. In other cases, a multidisciplinary treatment approach incorporates nutritional modifications, environmental changes, physical therapy, and pain management.

You will receive a thorough diagnostic evaluation and receive clinically-proven treatment by a board-certified urologist who specializes in female pelvic pain. Our goal is to alleviate symptoms so you can return to every life. Appointments are confidential and private.

Brigham and Women's Faulkner Hospital practices a multidisciplinary approach to patient care, routinely collaborating with colleagues in other medical specialties. If your urologist discovers that an underlying illness has contributed to your pelvic pain, you will be referred to an appropriate BWFH/BWH physician for an evaluation.