Woman's Health Centers

When Someone You Love Needs a Choice


Pelvic Pain

Pelvic pain can be caused by a variety of things. Many women report pelvic pain at some time in their life. There may be more than one reason for the pain. In some women the pain is intermittent (comes and goes). Other women may feel pain only during certain times of the month, and some others may experience chronic pelvic pain. Your doctor can work with you to determine possible reasons for the pain, and a treatment plan.

Pain may only occur during intercourse. This type of pelvic pain may have physical or psychological causes. During sex, a woman’s body goes through several changes. During the first stages of arousal when the vagina and vulva secrete moisture, the muscles in the vagina relax. The clitoris gets bigger as the blood flows into the pelvis. These changes also cause the vagina to get deeper and wider, preparing to receive the penis. If any of these changes do not occur, intercourse can be painful.

If a woman is not aroused, dryness may cause the vulva to be irritated or sensitive. The vulva is outside the vagina. Pain outside the vagina can also be caused by certain soaps, vaginal sprays, cysts, or an infection.

If pain is felt inside the vagina it may be caused by dryness. Pain in the vagina may also be caused by vaginal sores or infection. Some women find that a lubricant helps. Remember that only water based lubricants are safe to use with a condom. Other kinds of lubricants can cause the condom to break or become weakened. A frank discussion with your partner about what arouses you may help. Perhaps you need your partner to allow extra time for you to become fully aroused.

If a woman has vaginitas, such as a yeast infection, her vagina may also be irritated or inflamed. This can also cause pain in the vagina. If you have itching, burning, or a discharge, you may have vaginitis. Your doctor can prescribe medication to be used vaginally or an oral medication to treat vaginitis. These infections are usually treated with antibiotics. Once treated, the pain should improve within a few days. These infections may recur. Your doctor may recommend that your partner be treated also.

Pain on intercourse can also be caused when the muscles of the vagina do not relax during intercourse. Sometimes this happens due to scaring of the vulva or vagina from childbirth, infection or sensitivity to the condoms, spermicides or exposure to other irritants.

Sometimes this type of pain may be related to fear, past sexual abuse, or rape. Discuss this with your healthcare provider. Treatment may be helpful. Because sex is so closely tied to our emotions, pain on intercourse can be affected by our state of mind. Many emotional factors are at play. Fear of getting pregnant or of contacting an STD may cause an inability to relax during sex, or may cause a woman to not produce enough lubrication. Exploring the emotions tied to sex may help uncover a source of pain that can be treated with the help of a counselor.

If a woman experiences deep pelvic pain, she may have pelvic Inflammatory Disease, Endometriosis, Ovarian cysts or an Ectopic Pregnancy. For a diagnosis and treatment plan, see your doctor.

Sometimes, a Urinary Tract infection, or an infection of the bladder or kidneys can cause pain in the pelvic region. These types of infections usually are accompanied by pain on urination, strong urge to urinate, or pain in one or both sides. They are usually treated with antibiotics.

Ovarian cysts are fluid filled sacks. Some cysts are a normal part of the menstrual cycle. Often the cyst will go away as the woman’s period ends. A dull ache or heaviness in the pelvis may be due to cysts that do not go away. If these cysts cause sharp pains, it may be due to the cyst leaking fluid but not dissolving. Your doctor should be able to detect cysts during your pelvic exam. If a cyst causes problems and does not go away by itself, your doctor may advise surgery.

Fibroids are growths that occur on the inside of the uterus, on its outer surface, or deep in the walls of the uterus. They are not cancerous. Fibroids may cause heavier, more frequent periods with pain or pressure in the lower back or abdomen. Some fibroids may not cause any discomfort at all.

To determine the cause of your pelvic pain you will need to schedule a Well Woman Exam here at the Woman’s Health Center. Your doctor will review a detailed gynecological history, do a pelvic exam, and may order outside tests.

Some tests that are used to diagnose problems are:

  • MRI (Magnetic Resonance Imaging) This allows your doctor to see a picture of your internal organs, and pelvic structures.
  • Sonogram allows your doctor to see images of your uterus and ovaries with sound waves reflected off internal organs.
  • CT SCAN. This is an x-ray that shows internal organs.
  • Laparoscopy. This is a minimally invasive surgical procedure used to look up close at the organs.

There are so many other tests that can be ordered to determine the exact nature of the problem. Your doctor will order necessary tests of refer you to the proper specialist.