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Pelvic Pain

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Most women experience pain in the lower abdomen (below the belly button) time to time. It may be associated with their periods.


Causes originating from the reproductive system-

  • Endometriosis
    (This is a painful condition where tissue that is similar to the lining of the uterus grows outside the uterus.)
  • Simple spasmodic dysmenorrhea (excessive cramping pain during periods)
  • Pelvic inflammatory diseases
    (Infections of the lower pelvic organs can lead to scarring and abdominal pain)
  • Pelvic congestion
    (Large veins around your uterus and ovaries, similar to varicose veins, may cause pelvic pain)
  • Fibroids, which may cause a deep, dragging pain
  • Ovarian remnants
    (Some women experience pain even after removal of the uterus. This may be due to a small piece of ovary left inside in which painful cysts could develop.)
  • Ovarian cysts could cause pelvic pain, especially sharp or sudden if they get ruptured or twisted

Causes originating from the gastrointestinal system, for example

  • IBS (Irritable Bowel Syndrome)
  • Ulcerative Colitis

Causes originating from the urinary system
Bladder inflammations or urinary infections can all lead to symptoms of pelvic pain.

Pregnancy related causes

  • Ectopic pregnancy (pregnancy outside the uterus)
  • Abortions

Pain related to adhesions
Adhesions are scar tissues which are formed as a result of previous surgery or inflammation. These can lead to a dragging type of pelvic pain.

Risk Factors:

The two major risk factors to be considered are endometriosis and polycystic ovary syndrome.


In this disease the tissue (called as Endometrium) which normally lines the inside of the womb/uterus and which is normally shed off with blood during periods, grows outside the uterus and is seen involving ovaries and many other organs. Such types of cysts are very painful.

Polycystic Ovary Syndrome:

In this condition the follicles in which an egg normally grows and matures does not open and results in the formation of cysts.


Pain may be severe and steady or it may be intermittent, dull and aching type or may be felt just as a pressure sensation deep within. Some women may have pain during sexual intercourse.


Work up will depend upon the history, clinical examination etc. Apart from routine lab blood and urine tests, a pelvic ultrasound is of great help. Laparoscopy is considered as the gold standard in identification of the cause of the pain


Treatment is directed at the identified cause and laparoscopy affords a greater advantage over open surgery because of greater magnification and better identification of pathology.