Les douleurs pelviennes chez la femme
Many women suffer from pelvic pain. Whether chronic or acute, these pains of varying intensity can have several origins. It is important to identify the main cause, both to treat it correctly and to best relieve the pain.
Where are pelvic pains located?
Pelvic pains correspond to pain in the lower abdomen, the pelvis, and/or the pubis. Sometimes, they can even radiate posteriorly to the buttocks or the spine (in the lumbar region).
Although men can also suffer from pelvic pain, it is much more common in women.
It should also be noted that vulvar pain differs from pelvic pain. Similarly, in case of discomfort or feeling of heaviness in the lower abdomen, we will then speak of pelvic heaviness.
The different types of lower abdominal pains In general, two forms of pelvic pain are distinguished: acute and chronic.
Acute pelvic pain
First, we have acute pains. They appear suddenly and last less than 4 months. From mild to severe intensity, they can be constant or intermittent.
Urinary disorders (such as an acute cystitis), pelvic infection linked to an STD, or even ovarian torsion… Acute pelvic pains can result from various problems. Here are the main ones:
Pelvic pain during pregnancy
Firstly, many pregnant women experience pelvic pain, generally diffuse and global.
Indeed, the size of the uterus increases during pregnancy, progressively compressing the organs of the urinary and digestive systems. This compression can cause pain. Similarly, the pelvis gradually changes in preparation for childbirth, which can be potentially painful.
So, if you are experiencing pelvic pain during your pregnancy, talk to your obstetrician gynecologist. They will prescribe suitable exercises to help relieve you, while maintaining the necessary mobility in that area.
Additionally, intense pelvic pain can sometimes occur in early pregnancy, during the first trimester. In this case, immediately consult a health professional. A miscarriage or an ectopic pregnancy could be the cause of this pain…
In Menopausal Women
Furthermore, menopause also predisposes to the onset of pelvic pain. It causes major hormonal changes that then alter the functioning of the body.
For example, when menopause leads to digestive problems or constipation, pelvic pain can occur. Similarly, the decrease in estrogens often causes vaginal dryness, potentially triggering pain.
Pelvic Pain After Sexual Intercourse
Acute pelvic pain sometimes occurs after sexual intercourse – to be distinguished from dyspareunia (pain during intercourse). Very short-lived, they often result from involuntary muscular contractions.
However, if these pains are too frequent and/or bothersome, a consultation is advisable. The goal is then to rule out a possible endometriosis or a sexually transmitted infection.
During the Menstrual Cycle
Acute pelvic pains can also be related to the menstrual cycle. They are then acute cyclical pains, occurring at the same time of the cycle and with the same intensity.
According to women, they occur before, during, or after menstruation. It is also possible for ovulation to be painful.
Pelvic and lumbar pains
Finally, the lumbar region has a close connection with the digestive, urinary, and genital organs. This includes the pelvic floor, more commonly known as the perineum.
On one side, the different organs are attached to the lumbar vertebrae. When these organs are in distress, they can pull on the lumbar region and cause pain.
On the other side, the nerves connected to these organs come directly from the lumbar area. Therefore, a problem in this region (lumbago, lower back pain or other) can create pain in the abdomen and pelvic area.
Chronic pains
Then, when the discomfort lasts for more than 4 months, it is rather referred to as chronic pelvic pain. As varied as the acute version, these pains can be spontaneous or not, mild to severe, constant or not.
Chronic conditions and infections
Like the acute form, persistent and recurrent pains have a wide variety of potential causes. However, most often, chronic pains are suspected to be related to chronic conditions or infections (such as cystitis, constipation, chronic cough…).
After a surgical procedure, such as a cesarean section, scar tissue adhesions can also cause chronic pelvic pain.
Furthermore, such pains are also among the main symptoms of endometriosis.
Cystocele and other organ descents
Finally, it is possible that a cystocele (bladder descent into the vagina) is the culprit. Apart from vaginal heaviness, this type of genital prolapse sometimes leads to difficulty urinating and urinary incontinence.
Furthermore, the severity degree depends on the stage of organ descent. The fourth and final stage corresponds to a bladder completely protruding from the vagina.
If you are experiencing the main symptoms of cystocele, do not hesitate to consult. A simple pelvic floor rehabilitation could solve your problem. And in more severe cases, surgical treatment will be necessary.
What are the causes of lower abdominal pain?
In summary, the causes of pelvic pain are therefore difficult to identify. Potentially numerous, they can have various origins and even cumulate.
However, let’s recap the most common causes:
Furthermore, some pelvic pains are closely related to pathologies such as:
What to do in case of pelvic pain?
If you are experiencing pelvic pain, the first step is to consult a doctor. They will guide you according to your situation.
In addition, some causes are considered urgent and require immediate treatment. For example: appendicitis, peritonitis, or ovarian torsion.
In any case, the healthcare professional will start with a medical history. This interview will help identify the type of pain, their onset, and potential causes.
Usually, they will then perform a clinical examination, external and/or gynecological. A vaginal examination will help identify the painful area more precisely.
If needed, they may also prescribe additional tests such as:
How to relieve pelvic pain?
Finally, depending on the cause and severity of pelvic pain, the doctor will suggest one or several solutions to relieve it.
Treatments may then be medicinal and/or surgical:
Lastly, whatever your pelvic pains may be, remember to stay hydrated. Applying a heat source to the area will also help alleviate the pain.
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