PELVIC PAINS YOU SHOULD NEVER IGNORE

Knowing what’s normal and what’s not can help you do what it takes to feel better fast.

by K A I T LYN PI R I E

There’s a lot going on in the area between your navel and your privates, and as a result, many different things can cause pain there. In one study, 20% of the participants (who were women between ages 30 and 64) reported experiencing pain in their pelvic region, a general term for the lower abdominal area. And pinpointing the cause of the ouch and finding the right treatment can be difficult.

Endometriosis is a prime example: An estimated 10% of women suffer from the painful condition, yet it takes an average of eight to 12 years to receive that diagnosis.

Why is pelvic pain so mysterious? Your bladder, parts of your intestine and your rectum all sit in your pelvic cavity, in addition to reproductive organs and various muscles, points out Kiarra King, M.D., a board-certified ob/gyn in Chicago. Any of these could be the site of the pain, and some causes can’t be seen on imaging or in lab work. That’s why “patients have to be their own best advocates when it comes to pelvic pain,” says Sherry Ross, M.D., an ob/gyn and the author of She-ology.

The symptoms here are some of the most common among women.

Let your doctor know if you experience any so they can diagnose (and treat) the condition causing your discomfort. If your reproductive organs check out, see a gastroenterologist, a urologist or another specialist, suggests Dr. King, so you can keep sleuthing until you get the relief you need.

Pain while peeing

It’s likely a urinary tract infection (UTI). If you experience a burning sensation when you pee and feel the urge to go often, you probably have a UTI in your bladder. People with vaginas are prone to UTIs because their urethras are much shorter than those of people with penises, making it easier for infection-causing bacteria to get in and wreak havoc, says Karyn S. Eilber, M.D., a board-certified urologist with a subspecialty in female pelvic medicine and reconstructive surgery at Cedars-Sinai. Antibiotics are usually effective in killing off the bacteria, but if the pain worsens or you have a fever or nausea, see a doctor ASAP, because the infection may have spread to your kidneys.

Intense abdominal pain

It may well be endometriosis. If you are sidelined by severe cramping deep in your abdomen, endometriosis is a possibility. The condition occurs when tissue similar to the uterine lining grows outside the uterus, explains Iris Kerin Orbuch, M.D., a fellowshiptrained endometriosis excision surgeon and the coauthor of Beating Endo. The pain can flare at any time of the month, and because endometrial-like tissue can be found on any organ, symptoms may range from GI issues and heavy periods to back pain and fatigue. Treatment often includes meds or surgery.

Bladder discomfort

It could be interstitial cystitis

This occurs when the bladder’s lining is irritated — so you might feel the urge to pee, but little urine might come out. You might also experience pain or pressure in your bladder. Unlike a UTI, this condition tends to be chronic rather than acute.

No single treatment works for everyone, but your best bet is to see a urologist or a urogynecologist, who can explain your options.

Sharp pain on one side

Sounds like a possible ovarian cyst. When fluid collects on or within an ovary, it can form a cyst; if a cyst becomes large or ruptures, that can be painful. “It may get worse when you lie flat,” says Dr. Ross. Once imaging confirms a cyst, your doctor may suggest a “watch and wait” approach or surgical removal. “The characteristics of the cyst, the age of the person and the symptoms will determine the best course of action,” says Dr. King. For recurrent cysts that form after ovulation, you may be prescribed hormonal contraceptives, she adds.

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Consider pelvic inflammatory disease (PID). “If bacteria gain access to the inside of the uterus, the fallopian tubes or the ovaries, that can lead to pelvic inflammatory disease,” says Dr. King, “which can present with pelvic pain, discomfort, discharge, cramping and a positive STD screen, though it is possible to have PID due to bacteria not related to a sexually transmitted infection.” Your doctor will likely prescribe antibiotics to prevent the infection from spreading.

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Painful Periods

Maybe it’s fibroids. Many women develop these noncancerous growths in the uterus; they can cause pain when they put pressure on nearby organs or start to degenerate. “A degenerating fibroid is one that has outgrown its blood supply,” explains Dr. King. Without adequate blood supply, the tissue dies, which can lead to pain, she says. On top of discomfort, fibroids can cause constipation, urination problems and heavy or long-lasting periods. The location, size and number of your fibroids will affect your symptoms as well as the treatment your doctor advises, such as medications or a surgical procedure.

Pain during sex

This could be any number of things. Painful intercourse (dyspareunia) is something that up to an estimated one-third of women face in their lifetimes, research shows. Unfortunately, all the conditions on this list — as well as vaginismus (involuntary spasms), an STD, a lack of vaginal estrogen and psychological concerns — can make sex hurt. The good news: There’s usually a remedy for those problems, says Dr. King, though it takes a bit of detective work. People are often ashamed to admit when sex is painful, she says, “but that’s part of people’s health and well-being.” If you have pain, get checked out.

A: Isn’t it nice when someone else prepares your food once in a while? And takeout can be nutritious if you think smart. Pro tip: Portion sizes at restaurants are notoriously huge, so share with a friend or put half in the fridge—two meals for the price of one! The other important thing is to become fluent in “menu-speak.” Certain words can tip you off to high-calorie, high-sodium and high-sugar prep methods. Try to avoid dishes described as “heavy,” “rich,” “creamy,” “crunchy,” “tempura,” “crispy” or “smothered” in anything. Instead, look for terms like “baked,” “steamed,” “roasted,” “broiled,” “grilled,” “poached,” “seared” and “lightly sautéed,” which typically indicate healthier cooking techniques. Here are a few betterfor-you takeout swaps that still taste great.

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Flour Tortillas burrito

Shrimp Tempura burger & fries

Fettuccine Alfredo

Foods That Help You Heal

Inflammation isn’t inherently bad for you; it’s the body’s response to injury, and it helps it heal and repair itself. But chronic inflammation can wreak havoc on your health and contribute to pain and lifelong disease. Luckily, some of the best ways to combat chronic inflammation are in your kitchen. Here are the best foods to add and key ones to skip.

Eat daily: Olive oil, green leafy vegetables like spinach and kale, tomatoes, fatty fish like salmon and sardines, nuts and fruits such as berries and cherries. These foods are not only delicious but also packed with natural antioxidants, polyphenols and healthy fats that can all reduce markers of inflammation in the body.

Avoid: Fried, sugary, processed and refined foods, if you want to keep inflammation in check.

Corn Tortillas burrito bowl

Grilled or Steamed Shrimp open-face burger & baked potato

Pesto or Pasta

Primavera with Grilled Chicken

Corn tortillas have around half the calories and sodium, as well as twice the fiber, of their flour counterparts. They’re naturally gluten-free too.

A standard flour tortilla can have 320 calories and 50 g of carbs; add 40 g of carbs for rice and that’s nearly half a day’s carbs in one meal! Balance the bowl by opting for half scoops of the rice and beans, and double those fiery peppers and onions.

Battering and deep-frying shrimp (or veggies) tempura-style pushes up the fat and calorie counts. Go for grilled, steamed or poached; these cooking methods use little to no fat. Or try lightly sautéed, a good middle ground for lean proteins and vegetables.

Losing the top bun (or asking for a lettuce wrap) allows you to control the bread portion. And baked potatoes vs. anything fried? C’mon, no-brainer.

Skip the saturated fat and go for a hearty pesto instead. It may be high-calorie, but it is nutrient-dense and has a healthy fat profile as well as antioxidants. For lighter fare, add a protein (grilled chicken or shrimp) to a high-fiber, veggie-packed primavera.