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Categories > Menstrual Health > Pelvic pain

Body language: Understanding gynecological symptoms
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A twinge here, mild discomfort there—you may ignore gynecological aches and pains, thinking that they’ll go away eventually. But these signs are your body’s way of getting your attention. Although most symptoms are not cause for major alarm, they should be evaluated nonetheless. Fortunately, many gynecological conditions can be treated successfully with medication or simple, routine procedures.

If you notice any unusual signs such as those described in this article, call your doctor to set up an appointment. The information provided below lists some common causes of gynecological symptoms, but only a thorough medical exam can identify the exact cause of a problem and ensure appropriate treatment.

Symptom: Lower back or pelvic pain

Possible causes: Back pain that can’t be blamed on bad posture, physical exertion or spinal problems, or pelvic pain unrelated to menstrual cramps may signal gynecological trouble. Endometriosis (a condition in which the uterine lining grows outside the uterus) and pelvic inflammatory disease (PID) are the two most common reasons. PID occurs when bacteria enters the vagina and travels through the cervix to the uterus, fallopian tubes or ovaries. Medication can treat both endometriosis and PID. Some patients with endometriosis may need surgery.

Benign tumors, or uterine fibroids, may also cause lower back pain. Doctors can remove them with lasers or by using surgical methods.

Symptom: Painful intercourse

Possible causes: Discomfort during intercourse can deprive you of a healthy love life. Treating the conditions that cause this symptom—common culprits are menopause, endometriosis and vaginal infections such as trichomonal vaginitis (this causes a greenish-yellow discharge and is treatable with antibiotics)—can provide relief. During menopause, a decrease in estrogen production can cause vaginal tissues to become dry and less elastic, causing painful intercourse. In this case, water-based lubricants or menopausal therapies such as estrogen cream can bring significant relief.

Symptom: Abnormal vaginal bleeding

Possible causes: Bleeding occurring at any time other than when you would expect to have your menstrual period (or normal bleeding triggered by hormone replacement therapy) could signify fibroids, polyps (benign tumors of the uterine lining), ovarian cysts or, in some cases, endometrial cancer. If you bleed unexpectedly, call your healthcare provider immediately so he or she can get to the source of the bleeding.

You should also call if your menstrual bleeding is longer or heavier than normal. This could be a sign of a vaginal infection or adenomyosis, a condition in which uterine cells grow within the uterus’s muscular wall.

Symptom: Irregular vaginal discharge

Possible causes: PID, a yeast infection, trichomonal vaginitis or bacterial vaginosis (BV) may cause vaginal discharge. Yeast infections generally cause a cottage cheese-like discharge; trichomonal vaginitis, a foul-smelling greenish-yellow discharge; and BV, a thin, foul-smelling gray or white discharge. BV occurs when abnormal bacteria in the vagina outnumber the normal bacteria and should be treated with antibiotics. If left untreated, the condition, like PID, can lead to infertility and pregnancy complications, such as prematurity and low birth weight. For this reason, it is critical to distinguish yeast infection from BV before self-treating with an over-the-counter product. If you are unsure about the reason for the discharge, get an accurate diagnosis.

Symptom: Tenderness, redness or itchiness in the vaginal area

Possible causes: Vaginal discomfort can be caused by an infection or a Bartholin cyst. A Bartholin cyst is an infection of the glands that lubricate the vagina. When the glands cannot drain properly, a cyst develops that can be surgically removed. Genital herpes produce small, painful blisters in addition to itching. Antiviral drugs suppress symptoms of this sexually transmitted disease, which has no cure.

Another cause of vaginal discomfort is vulvodynia, or chronic vulvar pain. Doctors don’t know what causes the condition, but it may be tied to foods high in oxalic acid such as tea, chocolate and some fruits.

Symptom: Painful urination

Possible causes: Vulvodynia as well as fibroids, yeast infections, BV and urinary tract infections (UTI) may make urinating difficult or painful. Women with UTIs feel the need to urinate frequently and with urgency but only release a small amount of urine. UTIs are caused by bacteria that irritate the urinary tract. Antibiotics usually clear the infection in three days.

Painful urination together with back pain just above the waist may be a sign of an acute kidney infection and requires prompt treatment.