There has been much discussion in the newspapers recently on whether pelvic pain is being always properly diagnosed. It is common and can have a number of causes, and in particular endometriosis can go undiagnosed so make sure you know the warning signs, and how it differs from other conditions.

What is pelvic pain?

If you have pain below your belly button and above your legs, it counts as pelvic pain. It can be caused by a lot of things. It may be a harmless sign that you’re fertile, a digestive disorder, or a red flag that you need to go to the hospital.

These conditions are serious and need immediate attention

1. Appendicitis

If you have a sharp pain in the lower right part of your belly, are vomiting, and have a fever, it could be appendicitis. If you have these symptoms, go immediately to hospital.

An infected appendix may need surgery and, if it bursts, it can spread the infection inside your body. This can cause serious complications.

2. Ectopic Pregnancy

This happens when an embryo implants somewhere outside of the uterus and begins to grow. This usually happens in the fallopian tubes. Sharp pelvic pain or cramps (particularly on one side), vaginal bleeding, nausea, and dizziness are symptoms.

Get medical help right away as this is a life-threatening emergency.

3. Pelvic Inflammatory Disease

This is a complication of sexually transmitted diseases and is the No. 1 preventable cause of infertility in women. It can cause permanent damage to the uterus, ovaries, and fallopian tubes.

Belly pain, fever, abnormal vaginal discharge, and pain during sex or urination can be symptoms. Get it treated right away to avoid damage. It is treated with antibiotics.

In severe cases, you may need to be hospitalised and you also need to get your partner treated, too.

4. Ovarian Cysts

Ovaries release eggs when you ovulate. Sometimes a follicle doesn’t open to release the egg. Or it recloses after it does and swells with fluid. This causes an ovarian cyst. They’re usually harmless and go away on their own.

But they may cause pelvic pain, pressure, swelling, and bloating. And if a cyst bursts or twists, it can cause sudden, severe pain, sending you to the emergency room.

They can be diagnosed during a pelvic exam or ultrasound.

These conditions are common and need treatment

1. Endometriosis

Endometriosis is the development of uterine-lining tissue outside the uterus. Symptoms may include abdominal pain, heavy periods, and infertility. Treatment options include pain relievers, hormones, and surgery.

In some women, the tissue that lines the uterus grows outside of it. It can happen on the ovaries, fallopian tubes, bladder, intestines, and other parts of the body. When it’s time for your period, these clumps break down, but the tissue has no way to leave the body.

While this is rarely dangerous, it can cause pain and form scar tissue that may make it tough to get pregnant.

There are several treatment options including pain medications, birth control pills, hormones to stop periods, surgery with small incisions, and even a hysterectomy. As well as those options you could also use bioidentical natural progesterone to deal with the bleeding.

Tips for Living With Endometriosis

Dealing with the pain of endometriosis can be difficult but there are many ways to manage your pain and stress with some lifestyle changes so you can make yourself as comfortable as possible.

Dietary changes can help

Research has shown a link between endometriosis and diets that are low in fruit and vegetables and high in red meat. Some experts think the high amount of fat in meat like beef encourages your body to produce chemicals called prostaglandins, which may lead to more oestrogen production. This extra oestrogen (oestrogen dominance) could be what causes excess endometrial tissue to grow.

Research has also found foods rich in omega-3 fatty acids, like salmon and walnuts, to be helpful. One study showed that women who ate the highest amount of omega-3 fatty acids had were 22% less likely to develop endometriosis than the women who ate the least amount.

By comparison, women who ate the most trans fats had a 48% higher risk than those who ate the least, so the type of fat you eat matters.

Also, avoid alcohol and caffeine as caffeine seems to increase your chances of developing endometriosis, although researchers aren’t sure why. Alcohol is also associated with a higher risk.

2. Uterine Fibroids

These grow on or in the wall of the uterus and are not cancerous. Fibroids are common in women in their 30s and 40s and they usually don’t cause problems.

But some women may have pressure in the belly, low back pain, heavy periods, painful sex, or trouble getting pregnant.

Smaller fibroids can successfully be treated with bioidentical progesterone but if they are very large no hormones at all should be used.

3. Irritable Bowel Syndrome (IBS)

Unfortunately there is no agreement on what causes this and it can have a variety of symptoms including stomach pain, cramps, bloating, and diarrhea or constipation that keeps recurring.

Stress may also make the situation worse and helpful lifestyle changes include diet changes, stress management, homoeopathy has been found helpful as well. a

4. Mittelschmerz (Painful Ovulation)

Ever feel a painful twinge between periods? You may be feeling your body ovulate. When you do, the ovary releases an egg along with some fluid and blood. It can cause irritation. This feeling is called mittelschmerz — German for “middle” and “pain.” That’s because it happens midway through your monthly cycle. The pain may switch sides from month to month. It isn’t harmful and usually goes away in a few hours.
PMS and Menstrual Cramps

You can usually feel these cramps in your lower belly or back. They typically last 1 to 3 days. Why the pain? Every month, your uterus builds up a lining of tissue. That’s where an embryo can implant and grow. If you don’t get pregnant, the lining breaks down and is shed during your period. When the uterus tightens to push it out, you get a cramp. Try a heating pad and over-the-counter pain relievers to ease pain. Exercise and de-stressing can help, too. You can also talk to your doctor about PMS pain. Certain birth control pills or antidepressants may help.

5. Sexually Transmitted Diseases

Pelvic pain is a warning sign of some STDs. Two of the most common are chlamydia and gonorrhea (shown here through a microscope). You often get both at the same time. They don’t always cause symptoms. But when they do, you may have pain when you pee, bleeding between periods, and abnormal vaginal discharge. See your doctor. It’s also important to get partners checked and treated, too, so you don’t pass the infection back and forth.

6. Urinary Tract Infection

Do you have to pee often, or does it hurt when you do? Or do you feel like your bladder is full? It could be a UTI. This happens when germs get into your urinary tract. Treating it quickly can keep it from it getting serious. But if it spreads to the kidneys, it can cause serious damage. Signs of a kidney infection include fever, nausea, vomiting, and pain in one side of the lower back.
Interstitial Cystitis (IC)

This condition causes ongoing pain and is related to inflammation of the bladder (illustrated here). It’s most common in women in their 30s and 40s. Doctors aren’t sure why it happens. People with severe IC may need to pee several times an hour. You might also feel pressure above the pubic area, pain when you urinate, and pain during sex. Although this can be a long-term condition, there are ways to ease the symptoms and avoid flares.

7. Chronic Pelvic Pain

If you have pain that lasts at least 6 months, it’s considered chronic. It may be so bad it messes with your sleep, career, or relationships.

Most of the conditions we’ve covered get better with treatment. Sometimes, even after a lot of testing, the cause of pelvic pain remains a mystery. But if it persists for several months then see your doctor.

8. Pelvic Organ Prolapse

As you get older, this may happen. Your bladder or uterus drops into a lower position. It usually isn’t a serious health problem, but it can be uncomfortable.

You may feel pressure against the vaginal wall, or your lower belly may feel full. It may also give you an uncomfortable feeling in the groin or lower back and make sex hurt.

Special exercises like Kegel’s or surgery may help.

9. Pelvic Congestion Syndrome

We’ve all seen varicose veins in legs bur they can sometimes happen in the pelvis, too. When blood backs up in veins, they become swollen and painful. This is known as pelvic congestion syndrome.

It tends to hurt worse when you sit or stand. Lying down may feel better. It usually can be treated with procedures using very small incisions..

10. Vulvodynia

Does it hurt when you ride a bike or have sex? If it burns, stings, or throbs around the opening of your vagina, it could be this. The feelings can be ongoing or come and go.

Before you’re diagnosed with this, your doctor will rule out other causes and treatment options range from medication to physical therapy.

11. Painful Sex

This can be caused by many things. Most are treatable. It could be a vaginal infection, or you just may need more lubrication. Sometimes the pain gets better after sexual therapy. This type of talk therapy can focus on inner conflicts about sex or past abuse.

Painful, dry, sex can be helped by a combination of progesterone and oestrogen.

12. Scar Tissue

If you’ve had surgery or an infection, you could have ongoing pain from this. Adhesions are a type of scar tissue inside your body. They form between organs or structures that aren’t meant to be connected.

Adhesions in your belly can cause pain and other problems, depending on where they are. In some cases, you may need a procedure or surgery to get rid of them