Pelvic pain

Pelvic pain is discomfort felt in the lower part of the abdomen, below the navel. Because so many organs sit in the pelvis, it has a wide range of causes, and the pattern — sudden or gradual, cyclical or constant, and the accompanying symptoms — points toward the source. Gynaecological causes are prominent in women: period pain, endometriosis (pain often worse around periods and during sex), uterine fibroids, ovarian cysts (which can cause sudden severe pain if they twist or rupture), pelvic inflammatory disease from infection, and, importantly, an ectopic pregnancy — a pregnancy outside the womb, which is an emergency. Urinary causes include bladder infections and kidney stones. Bowel causes include constipation, irritable bowel syndrome, diverticulitis and appendicitis (classically pain moving to the lower right). Chronic pelvic pain lasting months can arise from endometriosis, chronic bladder or bowel conditions, adhesions, or musculoskeletal problems. Because the causes range from benign to emergencies, the timing matters: sudden, severe pelvic pain, pain with fever, or pelvic pain in early pregnancy needs urgent assessment, while long-standing pelvic pain deserves a proper, structured work-up.

• Gynaecological — period pain, endometriosis, fibroids, ovarian cysts (sudden pain if they twist or rupture), pelvic infection.
• Ectopic pregnancy — a pregnancy outside the womb; an emergency.
• Urinary — bladder infection, kidney stones.
• Bowel — constipation, irritable bowel syndrome, diverticulitis, appendicitis.
• Chronic pelvic pain — endometriosis, adhesions, bladder or musculoskeletal causes.

Pelvic pain is assessed from the history and examination, with a pregnancy test essential in anyone who could be pregnant (to detect an ectopic pregnancy), and pelvic ultrasound the key imaging test. Blood tests support the picture: a full blood count and CRP for infection or inflammation (as in pelvic inflammatory disease or appendicitis), and urine tests for infection or stones. CA-125 may be checked in specific situations relating to the ovaries, though it is non-specific and not a screening test. Endometriosis is not diagnosed by blood tests. Mediora.AI can surface a raised white cell count or CRP pointing to infection, or other patterns, but new severe pelvic pain — and any pelvic pain in early pregnancy — needs prompt in-person assessment, and chronic pelvic pain a structured work-up, by your doctor.