Pelvic pain is divided into acute and chronic, the former being a sudden onset short severe pain and the later more a long term pain which although often severe does not usually require admission to hospital. Around one million women in the UK suffer chronic pelvic pain which includes pain with periods, pain with intercourse, pain on opening bowels or just non specific pelvic pain. Causes can be both gynaecological and non gynaecological. Gynaecological causes include endometriosis, pelvic inflammatory disease, pelvic adhesions, adenomyosis (a condition where the lining of the womb ‘burrows’ into the underlying muscle), pelvic congestion syndrome, ovarian cysts and problems with the fallopian tubes. Pain can also occur if the ovaries become stuck down in the pelvis rather than being freely mobile. This can occur following surgery to the ovary, after hysterectomy, as a consequence of endometriosis or following infection and can be treated by temporary ovarian suspension. Non-gynaecological causes of pain include irritable bowel syndrome, urinary tract infections, painful bladder syndrome, musculoskeletal problems and nerve entrapment.
Investigation into the cause of pain usually involves taking a detailed history of the condition, examination and combinations of swabs, ultrasound scans and laparoscopy.