Copy of The Silent Symptoms: When to See a Doctor for Pelvic Pain

by Dr. LaSonya Lopez, MD

January 24, 2025

Introduction

Pelvic pain is a symptom that can disrupt daily life and signal underlying health issues. Despite its prevalence, it is often dismissed or ignored, leaving many women to suffer in silence. As a physician, I aim to help you understand when pelvic pain warrants medical attention and how you can advocate for your health.

What Is Pelvic Pain?

Pelvic pain refers to discomfort in the lower abdomen or pelvic region. It can range from sharp and intermittent to dull and constant. The causes are diverse and may involve muscles, nerves, or organs such as the uterus, bladder, or intestines. Understanding the type of pain and its source is crucial for effective treatment.

Common Causes of Pelvic Pain

Pelvic pain can stem from various conditions. Below, we explore the most common causes, their symptoms, diagnostic methods, and potential treatments.

Gynecological Conditions

Endometriosis

Symptoms: Severe menstrual cramps, chronic pelvic pain, pain during intercourse, heavy or irregular periods, and sometimes infertility.
Diagnostic Testing: Pelvic examination, ultrasound, and laparoscopy to confirm the presence of endometrial-like tissue outside the uterus.
Treatment Options: Hormonal therapies (e.g., birth control pills, GnRH agonists), pain management with NSAIDs, pelvic floor physical therapy, and surgery for severe cases.

Uterine Fibroids

Symptoms: Heavy menstrual bleeding, pelvic pressure or pain, frequent urination, and pain during intercourse.
Diagnostic Testing: Ultrasound for evaluation and MRI for detailed imaging if needed.
Treatment Options: Medications like hormonal birth control or GnRH agonists, uterine artery embolization, and surgical options such as myomectomy or hysterectomy.

Pelvic Inflammatory Disease (PID)

Symptoms: Pelvic pain, fever, unusual vaginal discharge, pain during intercourse, and irregular bleeding.
Diagnostic Testing: Pelvic exam, cervical swabs for STIs, and ultrasound to identify abscesses or inflammation.
Treatment Options: Antibiotic therapy; severe cases may require hospitalization or abscess drainage.

Ovarian Cysts

Symptoms: Sharp or dull pelvic pain, bloating, and irregular menstrual cycles. Large or ruptured cysts can cause significant discomfort.
Diagnostic Testing: Ultrasound to visualize the cyst.
Treatment Options: Observation for small, asymptomatic cysts; hormonal birth control to prevent future cysts; surgery for large or symptomatic cysts.

Bladder Disorders

Interstitial Cystitis (Painful Bladder Syndrome)

Symptoms: Chronic bladder pain, pressure, frequent urination, and pain during intercourse.
Diagnostic Testing: Cystoscopy, urine analysis, and a bladder diary to track symptoms.
Treatment Options: Dietary changes to avoid triggers, medications like pentosan polysulfate sodium, bladder instillations, and pelvic floor physical therapy.

Urinary Tract Infections (UTIs)

Symptoms: Burning during urination, frequent urge to urinate, cloudy or foul-smelling urine, and pelvic discomfort.
Diagnostic Testing: Urinalysis and urine culture.
Treatment Options: Antibiotics and increased fluid intake.

Digestive Issues

Irritable Bowel Syndrome (IBS)

Symptoms: Abdominal pain, bloating, diarrhea, constipation, or alternating bowel habits.
Diagnostic Testing: Stool tests, blood tests to rule out other conditions, and colonoscopy if red-flag symptoms are present.
Treatment Options: Low FODMAP diet, fiber supplements, antispasmodic medications, and stress management techniques.

Constipation

Symptoms: Infrequent bowel movements, hard stools, straining, and a feeling of incomplete evacuation.
Diagnostic Testing: Physical exam and imaging if chronic.
Treatment Options: Increased dietary fiber and water intake, over-the-counter laxatives, and pelvic floor physical therapy.

Musculoskeletal Problems

Pelvic Floor Dysfunction

Symptoms: Chronic pelvic pain, difficulty with urination or bowel movements, and pain during intercourse.
Diagnostic Testing: Pelvic floor muscle evaluation through physical therapy or ultrasound.
Treatment Options: Pelvic floor physical therapy, biofeedback, and trigger point injections.

Hernias

Symptoms: Localized pain or a bulge in the pelvic or groin area, worsened by coughing or straining.
Diagnostic Testing: Physical exam and imaging.
Treatment Options: Surgical repair.

When to See a Doctor

Pelvic pain should never be ignored, especially if:

It persists for more than a few days without improvement.
It disrupts daily activities such as walking, sitting, or intimacy.
You experience additional symptoms such as heavy bleeding, fever, painful urination, or changes in bowel habits.

Advocating for Yourself

Being proactive about your health is crucial. Here are steps to help you advocate for yourself:

Track Your Symptoms: Maintain a log of pain patterns, triggers, and alleviating factors.
Ask Questions: Clarify the purpose of diagnostic tests or treatments and explore all options.
Seek a Second Opinion: If your concerns aren’t being addressed, consult another healthcare provider.

Downloadable Symptom Tracker

Tracking your symptoms is a powerful step toward understanding your body and getting the care you deserve. Our Downloadable Symptom Tracker is designed to help you record the details your healthcare provider needs to create a tailored plan for your well-being.

How It Helps

Identify Patterns: By tracking symptoms over time, you can notice trends or triggers you might not have realized before.
Communicate Effectively: A detailed log makes it easier to describe your experience to your doctor.
Streamline Your Care: With accurate records, your healthcare provider can make faster, more informed decisions.

What to Record

Location and Type of Pain: Is it sharp, dull, throbbing, or burning? Where exactly are you feeling it?
Frequency and Duration: How often does the pain occur? How long does it last each time?
Potential Triggers: Are there activities or situations that worsen the pain?
Relief Strategies: Note any actions or remedies that provide relief.

How to Use

Download the tracker and print it out. There are also pain tracker apps that you can download.
Update it daily or whenever symptoms occur.
Bring it to your next medical appointment to share with your doctor.

Final Thoughts

Pelvic pain is not something you have to endure in silence. By understanding your symptoms and seeking timely medical care, you can take the first step toward relief. Let’s transform silence into strength and discomfort into empowerment.