Our pelvic floor muscles are located between our legs and run from the pubic bone (at the front) to the base of the spine (at the back). They are shaped like a sling of muscles and nerve endings which hold your pelvic organs (uterus, vagina, rectum, bowel and bladder) in place.

What Does Pelvic Pain Feel like?

Pelvic pain is experienced in the lowest part of the abdomen and pelvis. A woman may briefly experience a dull or sharp pain. It may also manifest itself as a sudden and brief discomfort (acute pelvic pain) or as a constant or intermittent pain for 6 months or longer (chronic pelvis pain). Pelvic pain can also vary in it’s severity. In fact, sometimes it is so intense that it feels like a hot poker is inside the vagina. In any scenario the pain may also transfer to the lower back, buttocks or thighs.

Pelvic Pain Associated With Gynaecological Problems or Pregnancy

Pelvic pain in women is commonly associated with the menstrual cycle but it can extend beyond this to include:

  • Adenomyosis
  • Endometriosis
  • Menstrual cramps (dysmenorrhea)
  • Ectopic pregnancy and intrauterine fetal death (or other early pregnancy-related conditions)
  • Mittelschmerz (ovulation pain)
  • Ovarian cancer
  • Ovarian cysts
  • Pelvic inflammatory disease (PID)
  • Uterine Fibroids
  • Vulvodynia (vaginal pain)

Other Causes of Pelvic Pain Amongst Amongst Women

While pelvic pain in women is commonly associated with the menstrual cycle, its origins can vary widely. It can develop from a range of pre-existing diseases and conditions, including:

  • Appendicitis
  • Colon cancer
  • Chronic constipation
  • Cholecystitis (gallbladder inflammation)
  • Enlarged spleen (splenomegaly)
  • Duodenitis (inflammation of the initial portion of the small intestine)
  • Scar Tissues (Abdominal Adhesions)
  • Fibromyalgia
  • Inguinal hernia
  • Interstitial cystitis (bladder syndrome)
  • Diverticulitis
  • Kidney stones
  • Pelvic Inflammatory Disease (PID) (pelvic floor spasms caused by muscular trauma)
  • Prostatitis
  • Ulcerative colitis
  • Salpingitis (inflammation of the fallopian tubes)
  • Urinary Tract Infection (UTI)
  • Pelvic Congestion Syndrome
  • Sexually Transmitted Infections (STI’s) 
  • Bladder and urinary problems (e.g. kidney stones)
  • Pelvic Organ Prolapse
  • Dyspareunia (pain during intercourse)
  • Interstitial Cysts (IC)
  • Digestive issues (e.g. irritable bowel syndrome)
  • Non-gynaecological origins (eg. muscular and ligament problems) around the pelvic floor
  • Irritation of the pelvic nerves

Recent gynaecologists have recently reported that chronic pelvis pain can arise from multiple conditions.

Clinical Diagnosis

Some situations, for example, ectopic pregnancy should be dealt with as an emergency. Other instances where severe pelvic pain suddenly develops, you don’t know what the underlying cause of the abdominal pain is or it keeps coming back then you should seek medical attention as soon as possible.

For conditions listed above our private gynaecologists will initially ask some questions before proceeding with a clinical examination.  The investigations typically include:

  • urine sample
  • screening for sexually transmitted infections, particularly chlamydia trachomatis and gonorrhoea
  • blood tests
  • ultrasound scans – diagnose ovarian cysts or if a miscarriage or ectopic pregnancy is suspected
  • MRI scans

In some instances further investigations are required. This is done using:

  • diagnostic laparoscopy (keyhole surgery) – here a small telescope is put through a small cut in your belly button. This allows the gynaecologists to see inside your pelvis