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Categories > Pelvic Pain and Disorders > Fibroids

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What’s behind your pelvic pain?

How to describe your pain

Keep a pain journal for at least one menstrual cycle in which you note the following:

  • Characteristics. Is your pain sharp, crampy, a dull ache or a heavy feeling deep in your pelvis? Is the pain steady or does it wax and wane? Does it radiate to your lower back and thighs?
  • When it’s worse. Do you feel greater pain when you sit or stand for long periods of time? Is it worse during a bowel movement, urination, your period or intercourse?
  • Other symptoms. Is menstrual bleeding heavier or prolonged? Do you have bloating, constipation, diarrhea, abnormal discharge, fever, nausea and vomiting, breast tenderness or frequent or urgent urination?

When is it an emergency?

Urgent conditions such as appendicitis, ectopic pregnancy or ovarian torsion or rupture will cause pelvic pain. Seek immediate care if your pain is severe and accompanied by:

  • tenderness around the navel or the right side of the abdomen
  • fever and vomiting
  • cold, clammy skin
  • rapid breathing
  • dizziness or weakness

Pain is your body’s way of saying something isn’t quite right. But when it comes to pelvic pain, it can be hard to pin down exactly what’s wrong. And because you may be accustomed to some monthly pelvic discomfort, it might not dawn on you that your symptoms aren’t what they used to be. When your pain changes, worsens, affects your daily life or seems to come with new symptoms, make an appointment with your doctor.

Some common causes of pelvic pain include:

Endometriosis. When endometrial tissue grows outside the uterus on your ovaries, fallopian tubes or other pelvic structures, it may cause pain and cramping in addition to painful periods with heavy bleeding. You may also have back or abdominal pain; pain with bowel movements or urination; or sharp, deep pelvic pain during intercourse.

Fibroids. One in four women with these benign uterine tumors experience symptoms that may include pelvic pressure or pain, heavy or prolonged periods, spotting, frequent urination, constipation and back or leg pain.

Ovarian cysts. You may feel a dull ache that radiates to your lower back and thighs, heaviness in your abdomen or pressure on your rectum or bladder. Most cysts will disappear within a few menstrual cycles. Sometimes, though, one will continue to grow and may rupture or twist (called torsion), causing sudden, sharp or worsening pelvic or abdominal pain.

Pelvic inflammatory disease. With this bacterial infection, you may feel pain in your lower belly and pain during a pelvic exam or intercourse. You may also have a fever, irregular bleeding and unusual discharge.

Don’t put up with pelvic pain or chalk it up to your period. See your doctor for a thorough exam during which he or she may also check for bladder or other infections, pregnancy, irritable bowel syndrome or nerve disorders. The sooner you seek treatment, the sooner you’ll enjoy relief.

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