6 Reasons Why You Have Pelvic Pressure and When to Seek Help

The pelvic region is one of the most sensitive areas of the body. For this reason, it is one of the worst places to be experiencing pain, and even more so when you are not sure why it is happening. It can be easy for relatives and even physicians to brush it off, but pelvic pain can be a symptom of something more serious.

Even if it is not, chronic pain can disrupt your life. From keeping you from getting your work done to interfering with enjoying time with your family, intense or chronic pain is an unwelcome guest to many, and you deserve to have yours taken seriously.

Although it isn’t always easy to get a physician to listen to you, you can trust yourself to know when there is something wrong. It is always okay to go to someone else for a second opinion if you feel like you aren’t getting the help you need.

Here are five common causes of pelvic pain and when you should contact a doctor about them.

Pelvic Venous Insufficiency

Pelvic pressure or groin pressure can be a sign of a vascular condition. If you experience severe period cramps or irregular periods, you may have a heightened risk of vascular conditions later in your life. Pelvic Venous Insufficiency is a vascular disorder affecting the veins of the pelvic region because there is not proper drainage of blood out of the region. It is most common in women who have more than one childbirth.

Risk factors of a vascular condition include:

• Multiple pregnancies - multiple pregnancies increase the chances of developing pelvic venous insufficiency. 
• Age - Vascular condition usually occurs during childbearing years or after. 
• Family history of venous insufficiency or vascular disease.
• Obesity - Obesity increases the chances of developing vascular conditions including pelvic venous insufficiency. 

Other related symptoms of a vascular condition could include:

• Chronic groin pain/pressure for more than 6 months
• An unusual degree of discomfort with menstrual cycles
• Pelvic pain during and/or after sexual intercourse
• A feeling of fullness in the pelvic region, vaginal region, labia and/or perineal region
• Swelling in the vagina, labia and/or perineal region
• Varicose veins might present in the upper thigh, vagina, labia, suprapubic and/or perineal region
• Frequency of urination
• Stress Incontinence   

The main sign of Pelvic Congestion Syndrome or Pelvic Venous Insufficiency is how long the pressure lasts, pain while intercourse, and/or after intercourse, and a high degree of discomfort during menstruation.

Period Pain or Menstrual Cramps

Part of the menstrual cycle involves shedding the lining of the uterus in absence of a pregnancy. Because the uterus needs to contract to do this, cramping of the pelvic area and pressure in the vagina often accompany menstruation.

Once you have had a few periods, you will know how period cramps feel. Sometimes they remain central to the pelvis itself, and sometimes they manifest as lower back pain. Period cramps can even cause a migraine headache. 

A certain degree of pain and discomfort is normal during your period and even at their best, they are no picnic. There are some cases, however, in which it’s appropriate to contact a doctor about them.

It's worth talking to your doctor about at your next appointment if:

• Your periods are gradually getting worse over time 
• You start bleeding more heavily than normal
• You begin to feel pain spread down your legs

You should bring it up if your period cramps accompany your fever.

If your pelvic pain accompanies chest pain or you lose consciousness, you should speak to a doctor right away rather than waiting for your appointment as these might constitute an emergency.

Infections

There are many causes of infections around the pelvis and vulva. One of the most common infections is a Urinary Tract Infection (UTI). Not only does it cause itching and painful urination, but also pelvic pain.

Many bacterial infections can cause pelvic pain, such as Gardnerella and staphylococcus. It is appropriate to see a doctor any time you suspect an infection to have this confirmed, and be prescribed antibiotics.

Finally, though itching is a more common symptom, a yeast infection can cause pelvic pain as well as the usual itching that accompanies it.

Although none of these are nice to go through, most people with vaginas will likely experience them at least once. Many things can cause an infection and no matter how meticulously you clean, it can still happen to you.

Endometriosis

During a regular period, the lining of the uterine wall thickens in preparation for an egg to implant. It sheds when that doesn’t happen. Sometimes, however, that lining builds up on the outside of the uterus instead. When the lining starts to shed, it can cause intense pain in the surrounding area.

This pain is often accompanied by heavy bleeding during periods, spotting between periods, and pain during bowel movements.

Although Endometriosis is diagnosed surgically, some physical examinations can help rule it out. Although there is no cure, the pain can be treated with medications and sometimes surgically.

People with Endometriosis often begin their periods at a younger age and experience infertility as a result.

Pelvic Floor Pain

The feeling of weight on the pelvic floor for six months or longer is one of the main symptoms of pelvic floor tension myalgia. The inability to control one’s pelvic floor muscles causes this pelvic pressure and pain

Other symptoms include:

• Difficulty defecating, 
• Lower back pain, 
• Pain during sexual intercourse 
• Pain that changes with repositioning of the body.

There are many causes of pelvic floor tension myalgia, and there is no way to guarantee you won’t ever develop it. Luckily, there are some things you can do to mitigate your chances, such as practicing good posture and maintaining a healthy weight.

Fortunately, with physical therapy, many people make a full recovery from pelvic floor tension myalgia. 

Bartholin’s Cyst

The Bartholin’s glands are a pair of small glands just behind and to either side of the vaginal lips. Their purpose is to secrete fluid to lubricate the vagina and are small enough so that they are barely noticeable unless there’s something wrong.

In the case of a Bartholin’s cyst, the ducts leading from these glands to the vagina become blocked, which causes the ducts to expand. It is possible for this to happen and not cause any symptoms at all, but in some cases, the cysts can be painful.

The forming of Bartholin’s cysts is sometimes linked to sexually transmitted infections. They are not always, however, related to an STI, and though physicians are not sure what all causes them they are most likely to be experienced by sexually active individuals in their 20s and 30s.

Bartholin’s cysts are very rare in people who have not yet started their periods, or in postmenopausal patients as Bartholin’s glands are not as active during these years.

Any time the pain from the pelvic pressure has become too much, it is worth it to at least talk to your doctor about what is happening to you to see if you can find answers. There are many causes of pelvic pain, some normal. However, any time the amount of pain you are experiencing disrupts your life, it is serious enough to speak to a doctor.

If you are bleeding very heavily, lose consciousness, or experience chest pain, do not wait for an appointment. Go to the emergency room.

When To Visit A Doctor About Your Pelvic Pressure

There are many potential causes of pelvic pressure in women. If your pelvic pressure has persisted for six months or more and you have had a gynecological evaluation to rule out a UTI, endometriosis, ovarian cysts, or other gynecological causes, consider seeing a vascular doctor as the problem may be vascular in origin.

When all gynecological conditions have been ruled out and there are no signs of fractures or musculoskeletal conditions, you are still experiencing extreme groin pain, and it has gone for 6 months or longer, then a vascular evaluation would be a great next step. The Center for Vascular Medicine highly recommends a gynecological evaluation but it is not a requirement when seeking vascular care for patients. 

How can a Vascular Specialist Treat Pelvic Pressure?

A vascular specialist uses non-invasive ultrasound to evaluate for any venous insufficiency. To confirm the findings, an IVUS and venogram are used by the vascular surgeon. A stent may be used by the physician to open the vein and decrease obstruction. This is a minimally-invasive procedure that is completed at one of the catheterization labs. This is not an open surgery because only a small incision is made to access the vein so hospital stays are not necessary for this procedure. The patient can usually resume light activity the same day depending on the recommendations of the physician. You can also seek advice from our Greenbelt vascular surgeon for medical guidance in this regard.

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