Ailmemts & Remedies

Pelvic pain

Pelvic pain is pain in the lowest part of your abdomen and pelvis. In women, pelvic pain may refer to symptoms arising from the reproductive or urinary systems or from musculoskeletal sources. Pelvic pain can occur suddenly, sharply and briefly (acute) or over the long term (chronic). Chronic pelvic pain refers to any constant or intermittent pelvic pain that has been present for more than a few months. It can affect both women and men.


Depending on its source, pelvic pain may be dull or sharp; it may be constant or off and on (intermittent); and it may be mild, moderate or severe. Pelvic pain can sometimes radiate to one’s lower back, buttocks or thighs.

Common causes in include: endometriosis in women, bowel adhesions, irritable bowel syndrome, and interstitial cystitis. The cause may also be a number of poorly understood conditions that may represent abnormal psychoneuromuscular function.

Most women, at some time in their lives, experience pelvic pain. As girls enter puberty, pelvic or abdominal pain becomes a frequent complaint.
Sometimes, it is noticed that pelvic pains only at certain times, such as when  urinating  or during sexual activity.

According to the CDC, Chronic pelvic pain (CPP) accounted for approximately 9% of all visits to gynecologists in 2007. In addition, CPP is the reason for 20—30% of all laparoscopies in adults.

Several types of diseases and conditions may cause pelvic pain. Often chronic pelvic pain results from more than one condition.

Pelvic pain may arise from one’s digestive, reproductive or urinary system. Recently, doctors have recognized that some pelvic pain, particularly chronic pelvic pain, may also arise from muscles and connective tissue (ligaments) in the structures of the pelvic floor. Occasionally, pelvic pain may be caused by irritation of nerves in the pelvis.

The different conditions that may cause pelvic pain includs:

*exaggerated bladder, bowel, or uterine pain sensitivity (also known as visceral pain)
pelvic girdle pain (SPD or DSP)


*Dysmenorrhea—pain during the menstrual period

*Endometriosis—pain caused by uterine tissue that is outside the uterus. Endometriosis can be visually confirmed by laparoscopy in approximately 75% of adolescent girls with chronic pelvic pain that is resistant to treatment, and in approximately 50% of adolescent in girls with chronic pelvic pain that is not necessarily resistant to treatment.

*Müllerian abnormalities

*Pelvic inflammatory disease—pain caused by damage from infections

*Ovarian cysts—the ovary produces a large, painful cyst, which may rupture

*Ovarian torsion—the ovary is twisted in a way that interferes with its blood supply

*Ectopic pregnancy—a pregnancy implanted outside the uterus


*Loin pain hematuria syndrome

*Proctitis—infection or inflammation of the anus or rectum

*Colitis—infection or inflammation of the colon

*Appendicitis—infection or inflammation of the bowel

Internal hernias are difficult to identify in women, and misdiagnosis with endometriosis or idiopathic chronic pelvic pain is very common. One cause of misdiagnosis that when the woman lies down flat on an examination table, all of the medical signs of the hernia disappear. The hernia can typically only be detected when symptoms are present, so diagnosis requires positioning the woman’s body in a way that provokes symptoms.

Female reproductive system:
Pelvic pain arising from the female reproductive system may be caused by conditions such as:

*Menstrual cramps (dysmenorrhea)
*Ectopic pregnancy (or other pregnancy-related conditions)
*Miscarriage (before the 20th week) or intrauterine fetal death
*Mittelschmerz (ovulation pain)
*Ovarian cancer
*Ovarian cysts
*Pelvic inflammatory disease (PID)
*Uterine fibroids

Other causes in women or men:
Examples of other possible causes of pelvic pain — in women or men — include:

*Colon cancer
*Chronic constipation
*Crohn’s disease
*Interstitial cystitis (also called painful bladder syndrome)
*Intestinal obstruction
*Irritable bowel syndrome
*Kidney stones
*Past physical or sexual abuse
*Pelvic floor muscle spasms
*Ulcerative colitis
*Urinary tract infection (UTI)

The diagnostic workup begins with a careful history and examination, followed by a pregnancy test. Some women may also need bloodwork or additional imaging studies, and a handful may also benefit from having surgical evaluation.

The absence of visible pathology in chronic pain syndromes should not form the basis for either seeking psychological explanations or questioning the reality of the patient’s pain. Instead it is essential to approach the complexity of chronic pain from a psychophysiological perspective which recognises the importance of the mind-body interaction. Some of the mechanisms by which the limbic system impacts on pain, and in particular myofascial pain, have been clarified by research findings in neurology and psychophysiology.

Differential diagnosis:
In men, chronic pelvic pain (category IIIB) is often misdiagnosed as chronic bacterial prostatitis and needlessly treated with antibiotics exposing the patient to inappropriate antibiotic use and unnecessarily to adverse effects with little if any benefit in most cases. Within a Bulgarian study, where by definition all patients had negative microbiological results, a 65% adverse drug reaction rate was found for patients treated with ciprofloxacin in comparison to a 9% rate for the placebo patients. This was combined with a higher cure rate (69% v 53%) found within the placebo group.

Many women will benefit from a consultation with a physical therapist, a trial of anti-inflammatory medications, hormonal therapy, or even neurological agents.

A hysterectomy is sometimes performed.

Spinal cord stimulation has been explored as a potential treatment option for some time, however there remains to be consensus on where the optimal location of the spinal cord this treatment should be aimed. As the innervation of the pelvic region is from the sacral nerve roots, previous treatments have been aimed at this region; results have been mixed. Spinal cord stimulation aimed at the mid- to high-thoracic region of the spinal cord have produced some positive results.

The sensation of pain travels through nerves up the spinal cord to the brain. Mild antidepressants like amitriptyline and gabapentin can block these transmissions and relieve the pain. They are especially effective if combined with anti-inflammatory medications like ibuprofen.

IBS and food allergies should also be tackled. Sometimes avoiding milk or wheat or both, and tackling abnormal gut motility works.

Physical activity reduces pain to an extent. Walking, jogging or running for 40 minutes a day is important. This should be combined with stretching and pelvic exercises. And if there is stress, cut it down with yoga and meditation.

Kegel exercise  or pelvic floor exercise   is most effective for Pelvic pain

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Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.


Health Quaries

Some Health Quaries & Answers

Varicose Veins.:-
Q: I am 71 years old and have varicose veins in both legs. They ache, pain, prick and cause me a great deal of trouble. I wear the prescribed stockings but in summer the legs itch unbearably. I take precautions like not standing in one place for a long time. I also keep my feet elevated while lying down. I cannot sleep because of the pain. I saw an advertisement for natural treatment. What should I do?

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A: Compression stockings are effective if used properly. They have to be put on the first thing in the morning and then worn all day. They act by steadily squeezing the leg muscles so that the blood in the veins moves more efficiently. If the pain remains unbearable despite this, there are several surgical treatment options like laser, stripping, clipping, and endoscopic surgery.

Advertisements claiming “unique”, “permanent” or “painless” non-surgical methods or alternative medications to cure varicose veins may seem appealing. But it pays to be a cautious. The results are often unsatisfactory. Clarify health risks, the possible side effects and costs before actually undergoing any procedure or taking any non-prescribed medication.

Cervical cancer:
Q: My mother has cervical cancer and I am worried that I may get it too. What can I do?

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A: Breast and ovarian cancers are associated with changes in certain genes (BRAC1 and BRAC2) which can be inherited, but cervical cancer does not fall in this category. It does not run in families. The main risk factors for the development of this cancer are sex at a young age, multiple partners, smoking and infection with the human papillomavirus (HPV).

• The best protections against cervical cancer are:

• protected sex using a condom

• not smoking

• having a regular cervical smear (pap smear) once every three years if you are under 50 and every five years after that.

Immunisation against HPV is now available and can be given from the age of nine years.

You may click to see:->Womens Health Issues

Q: I have been married for nine years and am 33 years old. I was found to have bilateral hydrosalpinx. I want to conceive. Doctors are suggesting IVF ( in vitro fertilisation) by clipping both the fallopian tubes. Is there any other way?

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A: The fallopian tubes carry the egg to the uterus. In bilateral hydrosalpinx, both the fallopian tubes are blocked with fluid. This greatly reduces the chances of a normal pregnancy. If an egg is fertilised, there is a good chance that it may be unable to proceed further and remain and develop in the tube itself. This is called an ectopic pregnancy and is dangerous. By clipping the tubes and placing the fertilised egg directly in the uterus, the doctor is ensuring that this does not occur and that the pregnancy proceeds smoothly.

You may click to see:->

Delayed urination
Q: I cannot urinate immediately when I feel like doing so. There is a delay during which I have to strain and concentrate. There is no pain. I did not have this problem earlier. I was told that I have developed a large bladder capacity and that there was no need to worry.

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A: The bladder does not suddenly enlarge. It is likely to do so if there is an obstruction, like an enlarged prostrate, in the outflow tract.

Straining to pass urine shows that this must be the case. It can eventually cause a backward flow of urine into the ureters (tubes arising from the kidney) from the bladder. This will cause urinary tract infection. The condition needs further investigation, with an ultrasound of the abdomen and X-rays. It cannot be dismissed lightly. You need to see an urologist.

You may click to see:->Prostate Enlargement: Benign Prostatic Hyperplasia

Bald dad
Q: I am a 19-year-old girl and my 50-year-old father has got a bald patch over his head. Will I develop one too?

A: Baldness occurs through the expression of a gene carried on the X chromosome. Women receive two X chromosomes, one from the father and one from the mother. Even if one chromosome (from the father) carries the gene for baldness, it is balanced by the other normal gene. Women are also protected to some extent by their female hormones. They can become bald or lose hair after menopause if both their X chromosomes carry the baldness gene. It is usually a much milder form than that which occurs in men.

Can’t eat bananas :-
Q: My 17-year-old daughter always has palpitations if she is forced to eat bananas. Why?

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A: Bananas contain a chemical called serotonin. Some people can have an allergic reaction to serotonin and develop symptoms like abdominal pain, cramping and palpitations. Most food allergy or food intolerance reactions usually happen within a few minutes to a few hours after eating. Most mild to moderate reactions last less than a day. Sensitivity and its symptoms can increase over time unless bananas are avoided.

Sources: The Telegraph (Kolkata, India)