Health in the City: Pelvic pain

London Mums have joined forces with BMI Healthcare to encourage women in London to be more aware of the issues surrounding their health and wellbeing in the capital. In this article we look at the issue of pelvic pain and its possible causes.

pelvic pain piece women chatting

Mittelschmerz’ pain

Period pain is something many women are familiar with, but some also experience pain mid-way between periods. This is known as mittelschmerz (from the

German, ‘mid’ and ‘pain’) and is often a pain associated with ovulation. The ovary releases an egg along with some fluid and blood, which may irritate the lining of the abdomen. You may find the pain switches sides from month to month, and although uncomfortable it doesn’t signify a problem and usually fades quite quickly.


Premenstrual syndrome (PMS)

Most people think of mood swings when they think of PMS, but it can also be the cause of abdominal cramps, low back pain, headaches, tender breasts and acne. If PMS is affecting your life, have a chat with your GP. PMS can be made worse by stress and a lack of certain vitamins and exercise. You may find that certain lifestyle changes and medication can help.


Menstrual cramps

Each month your uterus gets busy building up ‘endometrium’, a lining of tissue ready for a growing embryo. But if you aren’t pregnant, the lining breaks down and leaves the body as your menstrual period. This is where cramps can occur as the uterus contracts to help expel this blood. You may feel these cramps in the lower abdomen or back. A hot water bottle or heated pad, and everyday painkillers, may help over the 1-2 days these occur.



Some women have a problem caused by the same endometrial tissue growing outside the uterus. Growths may form on the ovaries, fallopian tubes, bladder, intestines and other parts of the body. When you menstruate, these growths break down but the tissue has no way to leave the body. This can be painful and produce scar tissue that may also make it harder to get pregnant. Although there is no outright cure for this condition, it can be treated.


Ectopic pregnancy

This emergency condition occurs when an embryo starts to grow outside of the uterus – often in the fallopian tube. This is life-threatening and needs immediate treatment. The symptoms of an ectopic pregnancy include a sharp pelvic pain or cramps that are often located on one side. Other symptoms include vaginal bleeding, nausea and feeling dizzy. If you suspect an ectopic pregnancy, call 999.


Ovarian cysts

During your cycle a follicle accommodates the maturing egg and releases it when you ovulate. Now and again the follicle doesn’t open to release the egg, or it swells with fluid, forming an ovarian cyst. This is usually harmless and goes away by itself.

However, a large cyst may have symptoms including pelvic pain, weight gain and a frequent need to pee. If you’re concerned, talk to your doctor. A cyst can be spotted with a pelvic examination or ultrasound.


Uterine fibroids

Although fibroids are sometimes known as ‘fibroid tumours’, they are not associated with cancer. However, they can cause pressure in the abdomen, lower back pain, heavy periods and pain during sex. They can also cause problems if you are trying to get pregnant. Fibroids grow in the wall of the uterus and are common in women aged 30-40. Your doctor can suggest treatment to shrink or remove them.



Sufferers from Vulvodynia describe a burning, throbbing or stinging sensation affecting the area at the opening of the vagina. Frustratingly, no one knows the cause but we know it is not due to an infection. However, it can be treated using options such as medication and physiotherapy.


Pain during sex

Some of the conditions we have described above can cause ‘dyspareunia’, or painful sex. Other causes may be vaginal infections or a lack of lubrication. However, occasionally there is no obvious physical cause and sexual therapy may be a useful route to explore and resolve possible psychological problems.


For more information on the women’s health services available at BMI Healthcare please visit: or call: 0808 101 0337



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