Pelvic pain in women and men: symptoms, causes and treatment

Medically reviewed: 3, November 2023

Read Time:5 Minute

What causes pain in your pelvic area?

Pain in the pelvic region is not only a symptom of many diseases, but also one of the major factors determining the quality of life of a person. According to the WHO, every fifth person on earth suffers from pelvic pain.

Pain in the pelvic region occurs quite often in gynecological practice. It can be acute or chronic. To chronic carry the pain, lasting more than three months. Pain in the pelvic region can be caused, in addition to gynecological pathology, urinary system and gastrointestinal tract.

If there are slight pain in the middle of the menstrual cycle, do not worry. Some women experience pain during the period of ovulation, which is quite natural and does not threaten health.

Pelvic pain in women

Chronic pelvic pains are divided into permanent and episodic. Episodic pains are:

  • Algomenorrhea;
  • pain during intercourse.

Despite the fact that the internal female genitalia receive sympathetic innervation from the 10th thoracic (D 10) to the 2nd lumbar (L 2), the existing anastomoses between different segments can cause changes in sympathetic innervation, hence, the circulation of other abdominal organs, which clinically manifests an extremely diverse pain symptomatology.

Parasympathetic innervation receives the cervix from the sacral segment of the spinal cord through the sacral ganglia in the form of postganglionic fibers. With pathological stimulation of the parasympathetic nervous system, the effector organs can be: heart, bronchus, gall bladder, ureter and bladder.

What are the symptoms of pelvic pain?

The core of the clinical picture of the irritive vegetative syndrome (IVS) is the pain of different localization. They are usually obtuse, aching, evaluated as deep, gnawing, with a burning sensation (bake in the lower back) and internal raspiraniya, can be permanent or intermittent with increasing weather changes, under the influence of stressful situations, before and during menstruation.

Most often the pains are localized in the lumbar and sacral region, sometimes with irradiation in the legs along the inner surface of the thighs, into the inguinal region and the lower abdomen. In the last two cases they are often accompanied by peculiar sensations from the internal organs (burning in the stomach and intestines, rectum and bladder). Less commonly, patients complain of the following symptoms:

  • pain in the epigastric region;
  • pain in the chest, spine, joints.

Neurasthenic and vegetative-vascular disorders: paroxysmal, “pressing”, “compressive” headaches, mainly localized in the frontotemporal areas, sometimes in the half of the head; pain in the eyes, intensifying with the movement of eyeballs. In addition, experts note:

  • depressed mood;
  • increased sensitivity to temperature changes;
  • numbness of limbs;
  • cardiopalmus;
  • interruptions in the work of the heart;
  • disruption of the digestive tract (loss of appetite, nausea, pain, constipation).

There is increased irritability, incontinence, sleep disturbance (poor falling asleep, frequent awakenings). The mood of the patients is variable, they hardly concentrate, they quickly become tired.

With gynecological examination, patients can not detect significant changes – the uterus is of normal size, the appendages are not enlarged, the mobility of the internal genital organs is not limited. But at the same time, all women have pronounced soreness of the vaginal arches, sacro-uterine ligaments, and the pelvic wall.

Syndrome of chronic pelvic pain in women

Syndrome of chronic pelvic pain can be pain in the abdominal wall below the navel, the back of the neck, which lasts a fairly long time. Causes of prolonged pelvic pain in women:

  • urological;
  • gynecological;
  • gastroenterological;
  • cardiovascular disorders.

Urological disorders include the following diseases:

  • urinary tract infection;
  • cancer of the bladder;
  • cystitis;
  • urethral syndrome;
  • urolithiasis disease;
  • diverticulum of the urethra;
  • diverticulum of the bladder;
  • chronic inflammation of the paraurethral glands;
  • ureterocele.

Gynecological disorders are:

  • chronic inflammatory diseases of the pelvis (subacute salpingoophoritis, chlamydial salpingitis, tuberculosis salpingitis, chronic endometritis);
  • adhesive process in the small pelvis;
  • myoma, circulatory disturbance in myomatous nodes;
  • endosalpinia;
  • ovarian cysts;
  • parovarial cysts;
  • syndrome of ovarian remains (residual ovary) after surgical removal of the uterus and ovaries;
  • ovulatory pain;
  • varicose veins of the pelvis;
  • violation of outflow of menstrual blood in developmental anomalies;
  • cancer of internal genital organs;
  • postoperative lymphoid cysts;
  • idiopathic primary algomenorrhea (dysmenorrhea);
  • additional ovary;
  • stenosis of the cervical canal;
  • polyps of the endometrium or cervical canal;
  • rupture of the posterior sheets of the broad ligament of the uterus;
  • intrauterine contraceptive;
  • Prolapse (descent) of internal genital organs;
  • foreign body in a small pelvis.

In addition, the cause of pain can be endometriosis, in which tissue identical in structure to the endometrium grows outside the uterine cavity and simultaneously with the endometrium changes during the cycle. Endometriosis – proliferation of the mucous membrane of the uterus is characterized by chronic pain in the pelvic region, pain during menstruation and during sexual intercourse. Ectopic or tubal pregnancy also causes pain in this area.

Gastrointestinal diseases can cause pain in the pelvic region:

  • cancer of the large intestine;
  • chronic obstruction;
  • colitis;
  • constipation;
  • diverticulitis;
  • Crohn’s disease;
  • hernia;
  • irritable bowel syndrome.

Musculo-ligamentous, bone and neurological disorders can be as follows:

  • myofascial pain (myofascial syndrome) of the anterior abdominal wall, pelvic floor, other pelvic muscles and fibromyalgia, accompanied by spasms or tension of the pelvic muscles;
  • coccidonia – chronic coccygeal pain;
  • neuralgia;
  • tunnel neuropathy and tunnel pudendopathy in particular, including post-operative traumatic (entrainment of cutaneous nerves into the postoperative scar).
  • vertebral syndrome (lumbosacral osteochondrosis and herniated intervertebral discs, spine traumas, neoplasms of the spinal cord or sacral nerves);
  • abscess of the ilio-lumbar muscle;
  • ventral hernia, femoral hernia;
  • stretching, hematoma of the muscles of the lower abdomen;
  • degenerative diseases of the joints (pathology of the hip joint);
  • sarcoma of the ilium;
  • osteomyelitis of the ilium;
  • cardiovascular disorders in the pelvic area.

Among other common causes of pain in the pelvic area, doctors identify psychogenic pains:

  • stress;
  • depression;
  • psychogenic pain (stress, emotional problems – depression);
  • porphyria;
  • mesenterioadenitis (inflammatory lesion of the lymph nodes of the mesentery).

Causes of pelvic pain in men

In the modern classification of chronic prostatitis, category III has no obvious signs of infection chronic abacterial prostatitis / chronic pelvic pain syndrome. In men, the syndrome of chronic pelvic pain is up to 90-95% of all cases of prostatitis.

According to the generally accepted classification of prostatitis, there are:

  • syndrome of chronic inflammatory pelvic pain;
  • syndrome of chronic non-inflammatory pelvic pain.

The syndrome of chronic non-inflammatory pelvic pain accounts for 20 to 60% of all cases of prostatitis. With pain in the pelvic area, men should consult a urologist and women with a gynecologist. In addition, a consultation with a traumatologist is needed.