The following symptoms and complaints may occur together with acute or chronic pelvic pain:
Leading symptom
- Pelvic pain
Associated symptoms
- Fever
- Restriction of movement
- Abnormal vaginal bleeding
- Hypermenorrhea (increased menstrual bleeding; usually the affected person consumes more than five pads/tampons per day)
- Fluor vaginalis (vaginal discharge)
- Altered stool behavior
Cave (attention) to acute pelvic pain!
- Incarcerated hernia (hernia with critical entrapment of hernial contents in the hernial orifice) should also always be excluded.
- In the case of adnexitis (inflammation of the fallopian tubes and ovaries), the symptoms must regress after 48 hours under antibiotic therapy, otherwise there is suspicion of an abscess (encapsulated accumulation of pus)!
Cave (attention) in chronic pelvic pain!
- Women > 35 years and women with pelvic (“pelvic-related”) space-occupying lesions should always be presented to the gynecologist.
Warning signs (red flags) in acute pelvic pain
- Woman + unilateral abdominal pain + symptomatology between the sixth and ninth week of pregnancy → think of: Extrauterine pregnancy (gravidity in which nidation (implantation) of the blastocyte (embryo in the early stages of development) occurs outside the uterus (womb)); other possible symptoms include: Shoulder pain, due to irritation of the phrenic nerve (diaphragmatic nerve); Nausea (nausea), especially in the morning.
If sonography (ultrasound) does not reveal an intrauterine pregnancy when extrauterine pregnancy is suspected, laparoscopy should be performed. - Abnormal vaginal bleeding → think of: Abortion (miscarriage), extrauterine pregnancy.
- Fever → think of: Adnexitis (inflammation of the fallopian tubes and ovaries), urinary tract infection.
Warning signs (red flags) in chronic pelvic pain
- Woman + chronic pelvic pain → thank you to: Ovarian cancer (ovarian cancer)Notice. In about 85% of ovarian cancer patients, typical IBS symptoms occur newly and as the first symptom before cancer diagnosis! (About 6 months before diagnosis).
- Intrauterine device (IUD; coil) → thank to: exclude possible dislocalization (position control of the IUD).
- Lower abdominal discomfort, cycle-dependent or (later) cycle-independent → thank to: Endometriosis (occurrence of endometrium (endometrium) outside the uterus, for example in or on the ovaries (ovaries), tubes (fallopian tubes), urinary bladder or intestine).
- Meteorism (flatulence) + recurrent (recurring) pain in the lower abdomen → thank to: Irritable bowel syndrome (colon irritable; functional bowel disorder in which no causative disorders can be found).
