GYNECOLOGY

Pelvic Pain

Most likely

  • Primary dysmenorrhea
  • Mittelschmerz
  • Endometriosis
  • Adhesions

Serious disorders

  • Ruptured ectopic pregnancy
  • PID or pelvic abscess
  • Cancer (ovary, uterus, other)
  • Appendicitis

The evil quintuplet

  1. Endometriosis
  2. Irritable Bowel Syndrome
  3. Bladder Pain Syndrome/Interstitial Cystitis (BPS/IC)
  4. Pelvic Floor Dysfunction
  5. Pudendal Nerve Entrapment

Pitfalls

  • Ovarian torsion
  • Haemorrhage into ovary or cyst
  • Pedunculated fibroid
  • Endometriosis
  • Chronic constipation
  • ‘Pelvic congestion syndrome’
  • Misplaced IUD

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