Dysmenorrhea (painful periods)
Dysmenorrhea can cause many women to experience discomfort during their menstrual cycle. This pain can begin a few days before the period starts and then reduces as menstrual bleeding finishes. For a small percentage of women, the pain is severe and interferes with carrying out normal everyday tasks. There are two main types of dysmenorrhea: primary dysmenorrhea and secondary dysmenorrhea. In the first, the pain occurs within healthy women and is not related to any specific problem within the uterus or other pelvic organs. However, in the latter, the menstrual pain is linked to an underlying disease or structural abnormality within or outside the uterus, such as endometriosis, fibroid tumours and ovarian cysts, or from the use of an intrauterine device for birth control.
Possible symptoms can include:
For more information about dysmenorrhea (painful periods), its treatment and management, visit:www.pelvicpain.org.uk
Endometriosis
Endometriosis describes a condition where the lining of the uterus grows on the outside of the uterus. This can result in tissue attaching to the ovaries or fallopian tubes and sometimes to the bladder or intestines. This tissue is not shed during menstruation, unlike the lining of the uterus.
Possible symptoms can include:
For more information about endometriosis, its treatment and management, visit: www.endometriosis-uk.org and NICE guidance on Endometriosis.
Adenomyosis
Adenomyosis is a condition where the lining of the uterus starts to grow directly into the muscle wall of the uterus. During a period, the lining cells of the uterus bleed and the misplaced cells within the muscle wall also bleed which causes pain. Trapped in the muscle, the blood cannot escape from the cervix as it normally would. As a result, the blood and tissue accumulate and cause swelling in the uterine muscle wall.
Possible symptoms can include:
For more information about adenomyosis, its treatment and management, visit: www.pelvicpain.org.uk
Pudendal neuralgia and nerve entrapment
This condition can affect both men and women where the pudendal nerve has been damaged, trapped or irritated. It is usually a chronic condition and can be very painful and distressing. The pudendal nerve is a key nerve in the pelvis and runs through the lower buttocks, the area around the buttocks and genitals (perineum) and the area around the anus, as well the vulva, labia and clitoris in women.
Possible symptoms can include:
For more information about pudendal neuralgia and nerve entrapment, their treatment and management, visit: www.pudendalhope.info
Fibroids
Uterine fibroids are growths that can form on the inside walls of the womb (uterus) and they are also known as myomas or leiomyomas. They are made up of muscle and fibrous tissue and can vary in size; they are non-cancerous. It is possible that a woman might be unaware of their growth because fibroids don’t always cause symptoms. One in three women may experience them, most commonly between the ages of 30 and 50 years.
Possible symptoms can include:
For more information about fibroids, their treatment and management, visit: www.britishfibroidtrust.org.uk andNICE guidance on Heavy menstrual bleeding.
Cysts
There are various types of cysts that can appear under the skin or within other parts of the body. They are usually fluid-filled sacs of tissue and are usually benign (non-cancerous). Cysts often have no symptoms and can come and go without any associated problems or pain. However, if they grow large or become infected, they can become painful and unpleasant. Two kinds of cysts are associated with a woman’s reproductive organs: vaginal cyst and ovarian cyst.
Possible symptoms can include:
For more information about cysts, their treatment and management, visit: www.pelvicpain.org.uk
Pelvic inflammatory disease (PID)
PID is caused by an infection which can affect the pelvic organs such as the uterus, cervix and fallopian tubes. It usually involves sexual contact where bacteria enter the cervix and then spread, although it can develop as a result of childbirth, a termination of pregnancy or pelvic surgery.
Possible symptoms can include:
For more information about pelvic inflammatory disease (PID), its treatment and management, visit: www.rcog.org.uk
Vulval pain or vulvodynia
The vulva is the external area of a woman’s sex organs or genitals. It gives protection to the sex organs and the urinary tract. It is directly between a woman’s legs and is the key site of sexual arousal and response. Vulvodynia can affect women of all ages and in otherwise healthy women. It is persistent, unexplained pain around the vulva, the skin at the entrance to the vagina. It is often a long-term (chronic problem) and can be uncomfortable and distressing. The vulva may look no different but the pain may take a number of forms.
Possible symptoms can include:
For more information about vulval pain or vulvodynia, its treatment and management, visit: www.vulvalpainsociety.org or www.pelvicpain.org.uk
Pelvic organ prolapse
This is a condition where one or more pelvic organs such as the uterus, vagina, bowel and bladder, start to come down from their original positions within the pelvis and push against the vagina. This is often as a result of childbirth which can weaken the pelvic floor or damage the walls of the vagina.
Possible symptoms can include:
For more information about pelvic organ prolapse, its treatment and management, visit: our ‘Pelvic floor and PGP’ web page and www.rcog.org.uk
Pelvic cancer
As mentioned above, pelvic pain can be a sign of a number of different problems, but in rare instances it can indicate cancer.
Cervical cancer
A regular cervical/vaginal swab test for cancer is the best way to check for cervical health. Sometimes there are no apparent symptoms. However, it is possible to have symptoms with cancer that are similar to other conditions.
Possible symptoms can include:
For more information about cervical cancer, its treatment and management, visit: www.cancerresearchuk.org and www.macmillan.org.uk
Ovarian cancer
Ovarian cancer often develops without any obvious symptoms, and as a result it has been called the ‘silent killer’. It is not picked up through a routine vaginal swab test for cancer, but it is relatively rare.
Possible symptoms or signs can include:
For more information about ovarian cancer, its treatment and management, visit: www.cancerresearchuk.org, www.macmillan.org.uk and NICE guidance on Ovarian cancer.
Return to ‘If it’s not PGP, then what could it be?’ page.
Content added in 2017.
Charity Registered in England: 1100373
The Pelvic Partnership consists of volunteers who have had pelvic girdle pain (PGP) and wish to support other women. We aim to pass on information based on both research and the experience of other women with PGP. We are not medical professionals and cannot offer medical advice and the information we provide should not take the place of advice and guidance from your own health-care providers. Material on this site is provided for information and support purposes only.