Pelvic pain refers to any pain that occurs in the pelvic region, or pelvis, including the lower abdomen and genital area. They can be acute or chronic.

They are more frequent in women of childbearing age than in other categories of the population and are most often linked to urinary or gynecological causes. They can be benign or reflect the presence of a serious problem and should therefore prompt a consultation.

Acute pelvic pain is one of the most frequent reasons for emergency consultations.

Pelvic pain has various origins: gynecological, digestive, genitourinary, neurological, muscular, etc. In women, gynecological causes are found in about 50% of cases.

Among the main causes of acute pelvic pain (often requiring an emergency consultation) are:

• ectopic pregnancy: very painful and potentially fatal, it is due to the implantation of an embryo outside the uterus, for example in a fallopian tube
• a miscarriage
• salpingitis (infection of the fallopian tubes)
• a uterine fibroid or ovarian cyst that necroses or twists
• endometriosis
• an attack of appendicitis
• testicular torsion in men (very painful, this is a medical emergency)
• acute prostatitis

If the pain occurs in a young athlete, it could be a fracture of the sacrum or pelvis, bursitis or other musculoskeletal disorders (muscle tears, etc.).

Pelvic pain can also have an origin:

• digestive: irritable bowel syndrome, transit disorders, abnormal rectum (hemorrhoids, anal fissure, fistula)
• urinary tract: urinary tract infection (cystitis), renal colic
• rheumatologic.

To determine the cause of the pain, the doctor may perform an ultrasound, various imaging exams (MRI, CT scan), celioscopy, blood tests, etc.

Potentially very painful, acute pelvic pain can be caused by medical emergencies and should require immediate consultation.

Chronic pain, often linked to the female cycle, has a significant impact on the quality of life of women. They can also have consequences on the sex life, especially when they are disabling several days a month.

Everything obviously depends on the causes. Treatments can be drug or surgical. In case of ectopic pregnancy, terminating the pregnancy urgently is to save the life of the woman and avoid irreversible complications.

In women, in case of chronic pelvic pain, gynecological monitoring is necessary to ensure that there is no ovarian dysfunction or endometriosis, for example.

If no cause is found and a psychosomatic origin is suspected, psychotherapy follow-up may be offered. Pain in the lower abdomen and pelvis can indeed, in some cases, be associated with anxiety or certain psychological disorders.