Pelvic Pain as a Cervical Cancer Symptom

woman holding her hands over her pelvis as if in pain
Pelvic Pain and Cervical Cancer. Photo©Voyagerix

Pelvic pain is a symptom that affects many women and can be caused by a wide variety of problems, from premenstrual syndrome (PMS) to more serious conditions, like cervical cancer.

When it comes to cervical cancer, pelvic pain is experienced in the later stages of the disease. In fact, early cervical cancer rarely presents any symptoms.

What should you know if you are experiencing pelvic pain?

Symptoms of Pelvic Pain

Pelvic pain refers to pain or pressure felt anywhere in the abdomen below the navel. Pain may be intermittent or constant. Many women describe pelvic pain as a dull ache that may include sharp pains as well.

To help your doctor accurately diagnose the cause of pelvic pain, try to record information like when the pain occurs, what you were doing when the pain occurs, and what helps alleviate the pain. This can include laying down or taking over-the-counter medications to relieve pain.

Questions Your Doctor May Ask About Pelvic Pain

If you see your doctor with pelvic pain, she will ask you many questions about your pain. For example:

  • What is the quality of the pain? Is it sharp or dull and achy?
  • Where is the pain? Are you feeling discomfort primarily in your lower abdomen or does it spread into your back?
  • What makes the pain worse and what makes the pain better?
  • How severe is your pain? If a 10 means the worst pain you can imagine, and a one means you can barely feel it, what number would you give your pain?
  • How long has the pain lasted?
  • Is the pain steady, or has it been increasing? Does the pain ever come and go?
  • What other symptoms have you been having? Have your periods changed? Are the regular? Are they heavier or lighter than usual or do they last longer (or are they shorter)?
  • When was your last period?
  • Are you noticing any changes in urination?
  • Have you had a fever?
  • Have you had any new sexual partners, or do you have a history of PID?
  • What medical problems have you had?
  • Are there any medical problems involving female organs, or any conditions at all which run in your family?
  • Have you used any medications for your pain? How did they work?

Symptoms of Cervical Cancer

Cervical cancer usually has few symptoms in the early stages. This is why screening is recommended in order to find precancerous changes or early cancers. Possible symptoms of cervical cancer include:

  • Abnormal uterine bleeding - Dysfunctional uterine bleeding can take many forms. Your periods may be heavier than usual or last longer than usual.
  • Bleeding after intercourse. Keep in mind that this does not necessarily mean heavy bleeding, but may just be light spotting or a brownish red discharge.
  • Vaginal discharge or odor.
  • Pelvic pain, especially pelvic pain which arises during or shortly after intercourse.

Pelvic Pain is a Common Symptom of Many Conditions

Although pelvic pain is a symptom of cervical cancer and other gynecologic cancers, it is also the symptom of many other conditions. Some possible causes of pelvic pain include:

  • Constipation: Constipation is a common cause of pelvic pain, and is not always obvious. The pain may come and go (cramping) with contractions of the bowel or can be constant.
  • PMS (premenstrual syndrome): PMS can cause abdominal pain similar to that with a period, but may start before your period making it hard to recognize. This pelvic pain is often associated with other premenstrual symptoms such as irritability.
  • Urinary tract infections (bladder and kidney infections): Urinary tract infections can cause pelvic pain which may be severe. With a bladder infection people often have pain with urination as well, and with kidney infections, there is often a fever. Kidney infections may be felt primarily in the back, but there is a lot of overlap in symptoms.
  • Kidney stones: Kidney stones can cause excruciating pain which has been likened to that of childbirth. When the stones are closer to the kidneys, the pain is usually felt in the back. As a stone moves down the ureter (the tube between the kidney and the bladder) pain tends to move into the pelvis and groin. Kidney stones often cause blood in the urine, but this blood may only be able to be visualized under the microscope.
  • Endometriosis: Endometriosis, when uterine tissue grows outside the uterus, can cause tremendous pain which varies from one person to another. Pelvic pain associated with endometriosis often leads to painful periods, but this is not always the case.
  • Fibroid tumors: Fibroids are benign tumors that grow in or on the wall of the uterus. They are often asymptomatic but may cause chronic, low-grade pelvic pain.
  • Ovarian cysts: Ovarian cysts are fluid-filled sacs that occur on the ovaries. These cysts can grow quite large before causing any pain. When they are large they can cause pelvic pain due to pressure on surrounding structures. Pain can be severe when they rupture. A common scenario is chronic pain which slowly worsens, becomes extreme, and then lessens as the cyst ruptures.
  • Ectopic pregnancy: An ectopic pregnancy (tubal pregnancy) can cause pain similar to an ovarian cyst in that it can be low grade, then become very severe, and lessen somewhat if it ruptures. With an ectopic pregnancy, however, rupture is a medical emergency. Ectopic pregnancies often occur only a few weeks after a woman misses her period, and women who do not keep careful track of their periods may not yet realize they are pregnant.
  • Pelvic inflammatory disease: Pelvic inflammatory disease is a fairly common cause of pelvic pain and is serious, in that it can lead to scarring which, in turn, can cause infertility and chronic pain. Some women will have vaginal discharge or other symptoms, but some women will only notice a mild gnawing pelvic pain.
  • Ovarian cancer: For years, ovarian cancer was called the "silent killer" in that women often had very few symptoms early on. We are now learning that pelvic pain may occur even early on with ovarian cancer and is a symptom that should be carefully evaluated.

There are many other possible causes of pelvic pain, ranging from hip problems to gastrointestinal problems and more. What is most important to remember is that even if pelvic pain is not related to cervical cancer there are other possible diagnoses that can be just as serious.

When Might Pelvic Pain Mean Cervical Cancer?

Pelvic pain related to cervical cancer may be indistinguishable from pelvic pain related due to other conditions. The risk is greater if you have had an abnormal Pap smear, have not had regular Pap smears, or have risk factors for cervical cancer such as a history of multiple sexual partners or human papillomavirus (HPV) infection.

Cervical Cancer Screening

Cervical cancer screening is recommended for anyone who may be at risk of developing cervical cancer. Current guidelines for cervical cancer screening take into account possible risk factors and more.

When to See a Doctor for Pelvic Pain

Women who experience regular pelvic pain should have it evaluated by a physician, even if they believe they know what is causing the pain. Mild cramping and pain associated with menstruation are normal, but severe pain or pain that is changing should always be evaluated.

Keep in mind that for most women, pelvic pain is caused by a benign condition that is not cancer-related . Yet even if it is not cancer, significant pelvic pain can have a large impact on a woman's life. Talk to your doctor. If you aren't getting the answers you need, you may wish to get a second opinion. Be your own advocate in your medical care.

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