During pregnancy a woman s body undergoes constant changes. The entire body tries to accommodate place for the growing uterus as hormones levels drastically fluctuate and ligaments stretched. Pelvic pain and the ensuing discomfort around this time is a common phenomenon experienced by most women. 

Though the pain may be harmless, at times it may also lead to serious repercussions. Therefore the identification of the causes that lead to pelvic pain during pregnancy is crucial. Some of them are: 

1. Accommodation pain: In the initial stages of pregnancy, women may experience cramps which are akin to the pain that precedes menstruation. However, in the case of pregnant women, the pain leads to no bleeding, but in all probability, is caused due to the expansion of the uterus.
2. Round ligament pain: Amidst the host of changes that the body goes through, the ligament that goes from the uterus to the groin also undergoes a change; it expands. This is responsible for the pain in the sides especially when women are walking or getting up from a chair.
3. Baby s weight: As the weight of the fetus begins to increase it exerts a pressure on the nerves that move from the vagina to the legs. This causes a dull pain in the pelvic region which increases considerably with walking and riding a car. This is most commonly felt by women who are in their third trimester.
4. Urinary Tract Infection: According to reports, most women suffer from urinary tract infection or UTI during pregnancy. This results in uncontrolled, often times, bloody urination and a pain in the abdomen. This is a major cause of concern as, if untreated, it infects the kidneys which in turn increases the risk of an early labour.
5. Miscarriage: In the first trimester, a pain in the abdomen may be an indication of a miscarriage. In such a situation, the pain is followed by bleeding and cramps.
6. Early labour: During pregnancy, an intermittent pain in the pelvic area and a back ache can also be suggestive of an early labour. If the contractions continue for over two hours after taking the necessary precautions like urinating and taking rest, it may be a sign of an early labor.

Pelvic Pain During Pregnancy

Pelvic pain is generally referred to as the pain in the lower abdominal region. Pelvic pain might be acute, sudden, or chronic, recurrent, cyclical in nature. It may present as central or lateralized pain and might spread to the thighs and buttocks. Pelvic pain might be an indication that something is wrong with the internal reproductive organs located in the pelvic region such as ovaries, fallopian tube, uterus and vagina in which case occurrence of pain may be related to particular time in menstrual cycle.

Pelvic pain can be indicative of a pelvic infection or related to the pelvic bones/spine problems.

Also it may indicate that there is something wrong with the digestive system or urinary system.

Causes-

The causes are as follows:

Pelvic pain occurs commonly in disorders of the internal reproductive organs such as ovarian cysts or pelvic inflammatory disease (where in sexually transmitted bacteria spread through the reproductive organs and cause infection) or pain during ovulation.

Pelvic pain might also occur due to endometriosis (a form of disorder where the endometrial tissues that are located inside the uterus tend to grow outside the uterus resulting in severe pain), adenomyosis (a disorder wherein the endometrial tissues which line the wall of the uterus tend to grow within the uterus), , pelvic adhesions or ectopic pregnancy (when the fertilized egg gets inserted somewhere else other than the main uterine cavity),

Pelvic pain can occur due to bladder disorders, kidney stones, infection in the urinary tract, constipation, flatulence,inflammatory bowel disease, irritable bowel syndrome and chronic hernia.

It can also be a symptom in some cancers such as ovarian cancer, colonic cancer, advanced ovarian , endometrial and cervical cancer.

The following symptoms might occur along with pelvic pain:

Sustained pain in the hips and the groin

Sudden fever

Severe pain while urinating , passing stools or during sexual intercourse (dysparuenia)

Vaginal bleeding or vaginal discharge .

Blood in stool

Severe menstrual pain ( dysmenorrhoea)

Repeated instances of constipation or diarrhoea

Increase In pain with stress and physical movements

Investigations-

The Gynaecologist will do physical examination including bimanual internal examination. Also, complete blood count, urine for microscopy, vaginal swabs if discharge, stool examination. Ultrasound examination of the pelvis is an important investigation.

Treatment-

If the pain is gynaecological and depending on the cause doctors might suggest different therapies. In cases where pain is due to an ovarian cyst or endometriosis, doctors may prescribe birth-control pills. In cases of suspected pelvic infection, antibiotics are prescribed. Also, laparoscopic surgery might be advised in cases of acute pain due to cyst, endometriosis, or pelvic adhesions: for confirmation of diagnosis and excision or removal of cysts and endometriotic implants and division of adhesions respectively. In some cases of chronic pain, the gynaecologist may manage the case with inputs from gastroenterologist and pain consultant.

Causes and Symptoms of Pelvic Pain

Pelvic pain is most common in women, though sometimes it occurs in men as well. There is absolutely no reason why pelvic pain cannot be treated and therefore women need not panic if they are experiencing such pain. The treatment of any pain can be done methodically after discovering its cause. Thus, before jotting down the treatments for pelvic pain, it is important to explore the reasons that cause pelvic pain in women.

Reasons for pelvic pain

Reproductive organs in women play an important part in causing pelvic pain. The reproductive organ is complex when it comes to women and many small or big problems there might end up leading to pelvic pain.
Any urinary infection or bladder irritation might also lead to pelvic pain.
The nerves and muscles of the abdomen may cause pain in the pelvis area as well. In fact, the nerves and muscles are very tender near the pelvis area and care should be taken so that one does not strain them or pull the ligaments. This can cause severe pain.
Another interesting point to be noted is that sometimes even after going through a lot of examinations, no causes of pelvic pain are found. In such cases it is understood that the pelvic pain is a manifestation of the remains of a long forgotten injury or accident.
It has been examined and found out that physical abuse can at times lead to chronic pelvic pain. Though this link has not yet been understood properly, but it is seen to be true.
Treatments for pelvic pain

The most basic treatment is to apply heating pad on the affected area. Heat helps in relaxing the muscles and nerves thereby, lessening the pain. However, this would reduce the pain, but cannot make it disappear in a day. Thus, it is a continued process for a week or 10 days till the pain recedes.
Relaxation techniques like meditation, breathing exercises, yoga and even muscle exercises like jogging help in reducing the pain. However, this should be done under guidance. One wrong move can actually aggravate the pain instead of lessening it.
Then there are painkillers which are non-steroidal and help in lessening the pain. Painkillers have a correct dosage and must be taken only after consulting a doctor. Self-medication in such cases can prove disastrous.
At times, when all medications fail, surgery is the last resort.
Thus, these are some of the treatments that can be undertaken if and when you are experiencing pelvic pain. All these are connected to the root cause and must be followed only under medical supervision.

Pelvic Pain - 4 Ways It Can be Treated

Pelvic Inflammatory Disease (PID)

Pelvic Inflammatory Disease, commonly called PID, is an infection of the female reproductive organs(uterus,fallopian tubules ovaries &cervix). PID is one of the most serious complications of a sexually transmitted disease in women: It can lead to irreversible damage to the uterus, ovaries, fallopian tubes, or other parts of the female reproductive system, and is the primary preventable cause of infertility in women.

Causes

Pelvic inflammatory disease (PID) occurs when bacteria move from the vagina or cervix into the uterus, fallopian tubes, ovaries, cervix
Most cases of PID are due to the bacteria that cause chlamydia and gonorrhea. These are sexually transmitted infections (STIs). The most common way a woman develops PID is by having unprotected sex with someone who has a sexually transmitted infection.

However, bacteria may also enter the body during some surgical or office procedures, such as:

 	Childbirth
 	Endometrial biopsy
 	Insertion of an intrauterine device (IUD)
 	Miscarriage
 	Therapeutic or elective abortion

Symptoms

Signs and symptoms of pelvic inflammatory disease may include:

 	Pain in your lower abdomen and pelvis
 	Heavy vaginal discharge with an unpleasant odor
 	Irregular menstrual bleeding
 	Pain during intercourse
 	Low back pain
 	Fever, fatigue, diarrhea or vomiting
 	Painful or difficult urination

PID may cause only minor signs and symptoms or none at all. Asymptomatic PID is especially common when the infection is due to chlamydia.

Other symptoms that may occur with PID:

 	Bleeding after intercourse
 	Chills
 	Fatigue
 	Frequent or painful urination
 	Increased menstrual cramping
 	Irregular menstrual bleeding or spotting
 	Lack of appetite
 	Nausea, with or without vomiting
 	No menstruation
 	Painful sexual intercourse

Diagnosis

 	Pelvic ultrasound. This test uses sound waves to create images of your reproductive organs.
 	Endometrial biopsy. During this procedure, a small piece of your uterine lining (endometrium) is removed and tested.
 	Laparoscopy. During this procedure, your doctor inserts a thin, lighted instrument through a small incision in your abdomen to view your pelvic organs.

Pelvic Inflammatory Disease (PID) - Causes, Symptoms & Diagnosis Of It!

In medical terms, the pelvic floor refers to a group of muscles in the pelvic area. These muscles provide support to the organs in the pelvic region, including the bladder, uterus (women), prostate (men), and rectum.

What is pelvic floor dysfunction?
This is a medical condition that is used to refer to a situation when you are unable to control the functioning of the pelvic floor. It means you fail to control the bowel movement. People suffering from pelvic floor dysfunction use these muscles to contract rather than to relax. It is for this reason that they cannot have a bowel movement. They often have an incomplete one.

What causes pelvic floor dysfunction?
In most of the cases, the exact reason behind this dysfunction is unknown. It is often believed that this condition is caused due to traumatic injuries to the pelvic area. This can happen after an accident and due to complications aroused after vaginal childbirth.

What are the symptoms?
There are several symptoms that are linked to this medical condition. You must visit your doctor if you come across the following signs:

The feel of having several bowel movements within a short period of time.
If you feel that you cannot complete a bowel movement.
When there is constipation pain linked with bowel movements.
A frequent urge to urinate.
Painful urination.
Pain in lower back.
Continuous pain in pelvic region, genitals, or rectum.
Pain during intercourse in women
How is pelvic floor dysfunction diagnosed?
It may be diagnosed through a physical examination by the doctor. You will ask several questions to know the case history and find out the cause. You may also be asked to take pelvic muscle control test by placing surface electrodes on the perineum or sacrum. A small device called a perineometer is also used for the same.

What are the best ways for treating pelvic floor dysfunction?
It can be treated without surgery. There are several techniques. Some of these are as follows:

Biofeedback: It is done with the help of a physical therapist.He uses special sensors to watch and monitor the muscles.
Medication: A low-dose muscle relaxant is prescribed to treat the same.
Relaxation techniques: Your therapist may ask you to take up techniques for relaxation such as warm baths, yoga, and exercises.
Surgery: If your physician finds out that the dysfunction is caused by a rectal prolapse or rectocele, he or she will take up surgery.
Pelvic Floor Dysfunction results in Urinary Dysfunction. Urinary incontinence is the unintentional passing of urine. It's a common problem thought to affect millions of people. There are several types of urinary incontinence, including:

Stress Incontinence   when urine leaks out at times when your bladder is under pressure; for example, when you cough or laugh
Urge Incontinence   when urine leaks as you feel a sudden, intense urge to pass urine, or soon afterwards
Overflow Incontinence (chronic urinary retention)   when you're unable to fully empty your bladder, which causes frequent leaking
Total Incontinence   when your bladder can't store any urine at all, which causes you to pass urine constantly or have frequent leaking
It's also possible to have a mixture of both stress and urge urinary incontinence.

Pelvic Organ Prolapse

Pelvic organ prolapse is a condition in which structures such as the uterus, rectum, bladder, urethra, small bowel, or the vagina itself may begin to prolapse, or fall, out of their normal positions. Without medical treatment or surgery, these structures may eventually fall farther into the vagina or even through the vaginal opening if their supports weaken enough.


Pelvic Floor Dysfunction - What is the Best Way to Treat it?

Pelvic pain is most common in women, though sometimes it occurs in men as well. There is absolutely no reason why pelvic pain cannot be treated and therefore women need not panic. if they are experiencing such pain. The treatment of any pain can be done methodically after discovering its cause. Thus, before jotting down the treatments for pelvic pain, it is important to explore the reasons that cause pelvic pain in women.

Reasons for pelvic pain

Reproductive organs in women play an important part in causing pelvic pain. The reproductive organ is complex when it comes to women and many small or big problems there might end up leading to pelvic pain.
Any urinary infection or bladder irritation might also lead to pelvic pain.
The nerves and muscles of the abdomen may cause pain in the pelvis area as well. In fact, the nerves and muscles are very tender near the pelvis area and care should be taken so that one does not strain them or pull the ligaments. This can cause severe pain.
Another interesting point to be noted is that sometimes even after going through a lot of examinations, no causes of pelvic pain are found. In such cases, it is understood that the pelvic pain is a manifestation of the remains of a long-forgotten injury or accident.
It has been examined and found out that physical abuse can at times lead to chronic pelvic pain. Though this link has not yet been understood properly, it is seen to be true.
Treatments for pelvic pain

The most basic treatment is to apply a heating pad on the affected area. The heat helps in relaxing the muscles and nerves thereby, lessening the pain. However, this would reduce the pain, but cannot make it disappear in a day. Thus, it is a continuous process for a week or 10 days until the pain recedes.
Relaxation techniques like meditation, breathing exercises, yoga and even muscle exercises like jogging help in reducing the pain. However, this should be done under guidance. One wrong move can actually aggravate the pain instead of lessening it.
Then there are painkillers which are non-steroidal and help in lessening the pain. Painkillers have a correct dosage and must be taken only after consulting a doctor. Self-medication in such cases can prove disastrous.
At times, when all medications fail, surgery is the last resort.
Thus, these are some of the treatments that can be undertaken if and when you are experiencing pelvic pain. All these are connected to the root cause and must be followed only under medical supervision.

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