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Pelvic Pain

Pelvic pain occurs mostly in the lower abdomen area.  The pain might be steady, or it might come and go.  If the pain is severe, it might get in the way of your daily activities.  Pelvic pain may be acute or it may be chronic.

Acute pelvic pain

Acute pelvic pain is a common presenting complaint in women.  The differential diagnosis includes gynecologic, urologic, musculoskeletal, gastrointestinal, vascular and metabolic disorders.  Gynecologists are frequently consulted to help determine whether the woman’s pain is from a gynecological or non-gynecological etiology.

The most common gynecological causes of acute pelvic pain are:

● Pelvic inflammatory disease and tuboovarian abscess
● Hemorrhage, rupture or torsion of an ovarian neoplasm.  Torsion of a normal ovary or fallopian tube is also possible.
● Torsion or degeneration of a uterine leiomyoma
● Endometriosis
● Endometritis
● Dysmenorrhea (pain during menstruation)


A thorough history and physical examination are usually necessary to narrow the possible diagnoses and focus the work-up.  A critical component of this process is to quickly identify the presence of conditions that are life-threatening and thus demand immediate surgical intervention.

Chronic pelvic pain

Chronic pelvic pain refers to pain of at least six months’ duration that occurs below the umbilicus and is severe enough to cause functional disability or require treatment.  This problem accounts for approximately 10 percent of all ambulatory referrals to a gynecologist and is a common indication for diagnostic and therapeutic surgery.


To decide on the best therapeutic plan for chronic pelvic pain, you and your physician should have a thorough discussion of your preferences and values regarding testing, medical versus surgical treatment, and childbearing plans.  For many patients, the optimal approach involves a combination of treatments.

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