Causes of Pelvic Pain in Women
A Pelvic pain in women can be caused by a problem in the pelvis or other parts of the body by irradiation. If there are events such as: dysmenorrhea, dyspareunia, we think of a pelvic cause, but you always have to raise suspicion of other conditions such as acute appendicitis, acute cholecystitis, intestinal obstruction, urinary infections.
Pelvic pain can be due to functional or organic causes.
1. Functional pelvic pain. It is a pain associated with ovulation (dull ache that occurs in the middle of the menstrual cycle, takes a few minutes). May be due to peritoneal irritation. Is confirmed by the short nature of pain and its appearance in the middle of the cycle. Premenstrual pain appears a few days before menstruation.
Primary Dysmenorrhea: uterine cramps that occur during ovulation, but in the absence of known pelvic diseases. The cause is an ischemia caused by prostaglandins. Treatment is with drugs that inhibit prostaglandin production or oral contraceptives.
2. Organic pelvic pain. Causes: uterine, adnexal, vulvar or vaginal associated with pregnancy.
Uterine pain. This pain has a chronic and permanent character and is higher during menstruation and sexual intercourse. Causes: uterine leiomyoma, adenomyosis, cervical stenosis. Other causes: uterine infection after dilatation and curettage maneuvers. Pelvic pain caused by endometrial or cervical cancer is usually a late manifestation.
Adnexal pain (tubes, ovaries). Common cause: infections. Appear: lower abdominal pain, fever and chills. It is due, usually, to chlamydia or gonorrhea infection, with or without pyogenic superinfection.
Chronic Pelvic inflammatory disease occurs after several episodes of infection. It causes sterility and chronic pelvic pain (more intense during menstruation and intercourse). This condition can be a medical emergency.
Ovarian cysts or cancers can give pain which become severe after torsion or rupture. Ectopic pregnancy should always be excluded as a possible differential diagnosis.
Endometriosis causes pain in the lower abdominal part and sterility. Endometriosis pain typically increases during menstruation and intercourse.
Vulvar or vaginal pain. Is mainly due to vaginitis caused by Monilia, Trichomonas and appear vaginal discharge and itching. Other causes: vulva herpes, acuminate warts, abscesses of Bartholin glands.
Pregnancy Disorders. During reproductive period pregnancy should be taken to discuss as a cause of pelvic pain. Imminent abortion or incomplete abortion can cause uterine contractions, bleeding which occur after a period of absence of the menstrual cycle. In ectopic pregnancy may occur bleeding in the peritoneum and complications that can lead to death.