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Am Fam Physician. 2010;82(2):148

See related article on acute pelvic pain

What is pelvic pain?

Pelvic pain is discomfort in the lower part of your abdomen or pelvis. It is acute if you have had it for less than three months. It is chronic if you have had it for three months or longer.

What causes it?

You have many organs in your pelvis and lower part of your abdomen. These include your reproductive organs (uterus, fallopian tubes, and ovaries), digestive tract (colon and rectum), and urinary tract. These organs can have problems that may cause acute pelvic pain. The most common serious causes are:

  • Pelvic inflammatory disease (an infection in your reproductive organs). This happens in women of reproductive age (women 15 to 25 years of age are at highest risk), and is usually caused by a sexually transmitted infection. It can cause infertility if not treated quickly.

  • Ovarian cyst (a fluid-filled sac that can grow on your ovary). It is often related to your monthly periods. If the cyst ruptures, it can cause pain and internal bleeding.

  • Appendicitis (ap-en-dih-SI-tis; swelling of the appendix). The appendix is a small pouch that sticks out from the beginning of the large colon.

  • Ectopic pregnancy (a pregnancy that grows in a fallopian tube or ovary). If the area of the ectopic pregnancy bursts, it can cause internal bleeding.

  • Endometriosis (en-do-me-tre-O-sis). This happens when tissue from the lining of the uterus is found outside of the uterus, usually in the pelvic cavity.

What other symptoms can I have with the pain?

You could have vaginal bleeding, dizziness, fever, nausea, and vomiting. See your doctor right away if you have pelvic pain and one of these symptoms.

How do I find out what is causing the pain?

Your doctor will ask you about your pain and do a physical exam. You may also need laboratory testing or imaging studies. Usually, an ultrasound (a test that uses sound waves to create a picture of your organs) is done.

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