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The pelvic region of the body is the lowest part of the abdomen between the hip bones. The perineum in women refers to the area between the vagina and anus. Pelvic and perineal pain involves discomfort in either or both areas.
Because the pelvic area and perineum are located near various organs, nerves, and muscles, pelvic and perineal pain is very common in women. The pain may come and go or be constant. The quality of the pain may vary based on the cause. The pain may be sharp, burn, or ache. Depending on the cause of the pain, symptoms may worsen when you move or use the bathroom.
In some cases, pelvic and perineal pain can be treated at home and does not require medical attention. But if symptoms become worse or persist, it’s a good idea to see your healthcare provider. Since pelvic and perineal pain can have many causes, it may take a little trial and error to make an accurate diagnosis.
To diagnose the condition, your doctor will perform a physical exam and review your symptoms. Additional tests may be ordered, such as blood tests to look for signs of a pelvic infection. A pelvic ultrasound may also be performed to check for cysts or inflammation.
Pelvic and perineal pain can have many causes. In women, it can arise from issues related to the pelvic organs, nerves, ligaments, and muscles. For example, cysts, endometriosis, and fibroids can lead to pelvic and perineal pain.
In addition, some of the more common causes include:
- Postpartum pain: After giving birth, it’s not uncommon for new moms to develop pelvic and perineal pain. The ligaments and joints of the pelvis often have added stress placed on them during pregnancy and delivery. Perineal pain can also develop due to stretching, tearing or an incision of the perineum during childbirth.
- Pelvic floor dysfunction: Pelvic floor dysfunction involves a problem tightening and relaxing the muscles of the pelvic floor. It can develop as a complication from a vaginal birth. In addition to pelvic and perineal pain, pelvic floor dysfunction can also cause a frequent need to urinate, urine leakage, and constipation.
- Adhesions: Pelvic adhesions are scar tissue that can develop due to prior surgery including cesarean sections. In addition to pelvic tenderness, adhesions may also cause infertility and painful intercourse.
Treatment for pelvic and perineal may vary depending on the underlying cause. In many instances, pain can be treated at home with the following:
- Wear an abdominal binder or compression garment: An abdominal binder or compression garment provides extra support to the muscles and ligaments of the pelvic area. It may be especially helpful if the pain is postpartum related.
- Apply ice: Applying ice to the painful area may decrease swelling and help ease the pain. Place a cold pack on the painful area for about ten minutes three or four times a day.
- Take nonsteroidal anti-inflammatory medication: Over the counter, anti-inflammatory medication, such as acetaminophen may reduce discomfort.
- Soak in a warm tub: Soaking in warm water may help improve blood flow to the area and promote relaxation, which might decrease pain. Instead of a soak in the tub, you can also apply a heating pad to the area.
The prognosis for women with pelvic and perineal pain is good. Usually, most causes of pelvic and perineal are not serious, and the condition can be treated at home. Most women recover well by using a combination of the above treatments.