Acute pelvic pain is a common symptom that brings women to the doctor's office, notes Fred Howard, MD at UptoDate. It is critical that the health care provider be able to quickly ascertain life-threatening causes of pelvic pain. A thorough history, physical exam and pregnancy test are required elements in diagnosing the cause of acute pelvic pain.
Pelvic Inflammatory Disease
Pelvic inflammatory disease is caused by bacterial infection within the uterus and fallopian tubes. This infection is caused by the sexually transmitted pathogens Chlamydia and gonorrhea. Symptoms of pelvic inflammatory disease include pelvic pain, vaginal discharge, fever and painful urination, notes the Merck Manual for Healthcare Professionals. Women infected with Chlamydia may have mild symptoms and go untreated for prolonged periods. Pelvic inflammatory disease can severely damage the fallopian tubes, making a woman infertile. It is critical that women with pelvic inflammatory disease be treated with the appropriate antibiotics in order to maintain their fertility.
Ruptured Ectopic Pregnancy
An ectopic pregnancy occurs when a fertilized egg implants itself outside of the uterus, usually within one of the fallopian tubes. The fertilized egg continues to grow and eventually ruptures the tube. According to the Merck Manual for Healthcare Professionals, women experiencing a ruptured ectopic can hemorrhage and go into shock quickly. There may be vaginal bleeding and severe cramping in the pelvis or abdomen. Women may feel a mass within the lower abdomen or pelvis. A ruptured ectopic pregnancy is a medical emergency.
Adnexal Torsion
Sudden severe pelvic pain accompanied by nausea and vomiting may indicate a twisting of the fallopian tube or ovary, called adnexal torsion. Twisting of the ovary or fallopian tube interrupts the blood supply, causing pain and possibly tissue damage. Adnexal torsion occurs in women of childbearing years. Risk factors include pregnancy, induction of ovulation and/or an enlarged ovary.
Endometriosis
Endometriosis is one of the common reasons for pelvic pain, says the Merck Manual for Healthcare Professionals. Endometriosis causes sharp cramping pain just before or at the beginning of a woman's menstrual period. It is often accompanied by painful urination, pain with intercourse and painful bowel movements. Eventually, women may experience pain outside of their periods and have uterine tenderness on physical exam. A health care provider may feel a fixed mass on the uterus during an exam.
