Pelvic Pain Flashcards
What is the most common cause of pelvic pain in women?
Primary Dysmenorrhoea
What is transient pain in the middle of the menstrual cycle called?
Mittelschmerz
Acute
A typical history is a female with a history of 6-8 weeks amenorrhoea who presents with lower abdominal pain and later develops vaginal bleeding
Shoulder tip pain and cervical excitation may be seen
Ectopic Pregnancy
Acute
Dysuria and frequency are common but women may experience suprapubic burning secondary to cystitis.
Urinary Tract infection
Acute
Pain initially in the central abdomen before localising to the right iliac fossa
- *Anorexia** is common
- *Tachycardia**, low-grade pyrexia, tenderness in RIF
- *Rovsing’s sign:** more pain in RIF than LIF when palpating LIF
Appendicitis
Acute
Pelvic pain, fever, deep dyspareunia, vaginal discharge, dysuria and menstrual irregularities may occur
Cervical excitation may be found on examination
Pelvic Inflammatory Disease
Acute
Usually sudden onset unilateral lower abdominal pain. Onset may coincide with exercise.
- *Nausea** and vomiting are common
- *Unilateral**, tender adnexal mass on examination
Ovarian Torsion
Acute
Vaginal bleeding and crampy lower abdominal pain following a period of amenorrhoea
Miscarriage
Chronic
Chronic pelvic pain
- *Dysmenorrhoea** - pain often starts days before bleeding
- *Deep dyspareunia**
- *Subfertility**
Endometriosis
Chronic
Extremely common. The most consistent features are abdominal pain, bloating and change in bowel habit
Features such as lethargy, nausea, backache and bladder symptoms may also be present
Irritable Bowel Syndrome
Chronic
- *Unilateral dull ache** which may be intermittent or only occur during intercourse. Torsion or rupture may lead to severe abdominal pain
- *Large cysts may cause abdominal swelling** or pressure effects on the bladder
Ovarian Cyst
Chronic
Seen in older women
Sensation of pressure, heaviness, ‘bearing-down’
Urinary symptoms: incontinence, frequency, urgency
Urogenital Prolapse
