If you experience pain in your lower abdomen or pelvis, it may be due to fallopian tube problems. This may be triggered by ovulation, pelvic inflammatory diseases, tubal blockage, ectopic pregnancy, or cancer. This article will provide you with information about the causes of pain as well as the symptoms, diagnosis, treatment, and prevention.
The fallopian tubes, also known as oviducts, are an important part of the female reproductive system, as they connect the ovaries to the uterus. When the egg is released by the ovary, it travels through the oviducts to reach the uterus. This period is considered to be most fertile for a woman. If a sperm meets the egg in the oviduct, it fertilizes the egg and starts moving towards the uterus. Hence, any problem in the fallopian tubes can cause difficulty in conceiving.
Ovulation
One of the most common, as well as the least serious cause of such pain is ovulation. When the ovaries release eggs, the oviduct pushes it to the uterus. During this process, the oviduct contracts itself in a rhythmic motion, which is likely to cause pain on either side of the lower abdomen. This pain usually increases with the follicle bursting and then, becomes dull.
Symptoms: Abdominal pain and pain during urination. Other symptoms include changes in the firmness of the cervix and breasts, spotting, vaginal discharge, increase in the body temperature, fever, and vomiting.
Diagnosis: Ovulation generally takes place around the fourteenth day from the first day of your cycle. Your doctor will be able to determine the condition by studying the dates of your menstrual cycle or by conducting an abdominal and pelvic examination.
Treatment: If the pain continues for 2-3 days, it would be a good idea to consult your doctor. You can also take regular pain killers which you take for menstrual cramps. Taking a lukewarm bath, or using heating packs, pads, and bottles can also help relieve the pain.
Prevention: You cannot completely prevent this pain as you ovulate every month. Your doctor may prescribe anti-inflammatory medicines to help decrease the pain.
Blockage
Fallopian tube blockage is one of the main causes of pain in the pelvic area. A woman’s oviduct may get blocked if she has a history of pelvic inflammatory diseases or sexually transmitted diseases. Prior abdominal and fallopian tube surgeries, uterine fibroids, genital tuberculosis, endometriosis, ectopic pregnancy, miscarriage, or a medical termination of pregnancy could be the other reasons.
Symptoms: Lower abdominal pain, anovulation, irregular periods, and white vaginal discharge.
Diagnosis: Usually, a tubal blockage is suspected when the woman is unable to conceive even after one year of unprotected sex. If the doctor doubts this, he will conduct a Hysterosalpingogram (HSG). Various other tests like laparoscopic chromotubation, hysteroscopy, sonohysterography, and ultrasound may also be conducted.
Treatment: Your doctor might conduct a surgery to open the tubes or remove the scar tissue that blocks the oviducts. The success rate depends on factors like your age, extent, and location of the blockage. However, like every surgical procedure, this too has its own risks, as it poses a threat for an ectopic pregnancy.
Prevention: Maintaining genital hygiene and practicing safe sex can reduce your chances of contracting pelvic inflammatory diseases and sexually transmitted diseases respectively.
Ectopic Pregnancy
This condition occurs when the fertilized egg attaches itself on the oviducts, instead of the uterus. Women who have pelvic inflammatory diseases, sexually transmitted diseases, or endometriosis are at a higher risk. Other reasons include excessive smoking, previous abdominal or tubal surgeries, fertility treatments like induction of ovulation through drugs, IVF, etc.
Symptoms: Abdominal pain, sharp pain on one side of the pelvic area, lower back pain, and pain during intercourse. Other symptoms include a missed menstrual cycle, excessive urination, weakness, diarrhea, vaginal bleeding, and spotting.
Diagnosis: The doctor will conduct pregnancy tests, pelvic examination, and ultrasound to determine the existence of an ectopic pregnancy.
Treatment: The only way out is to abort the fetus with the help of medicines or surgical procedures. A laparoscopy or laparotomy is carried out to conduct the medical termination of the pregnancy.
Prevention: Unfortunately, ectopic pregnancies cannot be completely ruled out. Using a condom every time you have sex will help in avoiding sexually transmitted infections which are a common cause of pelvic inflammatory diseases. Reduce cigarette smoking as it exposes you to a higher risk.
Cancer
One of the most serious and rare causes of such pain is cancer. Malignant cells develop on the fallopian tubes and spread to the other reproductive organs. The most common type of fallopian tube cancer is the papillary serous adenocarcinomas which affects the epithelial cells. Others include transitional cells (found in the lining of the tubes) and sarcoma (affects the muscles of the tube).
Symptoms: Pelvic pain, watery pinkish discharge from the vagina along with blood, and bloating.
Diagnosis: It can be diagnosed with the help of pap smear test, pelvic test, blood tests, ultrasound, MRI scans, CT scans, CAT scans, etc. A biopsy of the tissue is also conducted to determine the presence of malignant cells.
Treatment: A surgery is conducted to remove the affected tubes and ovaries, however, the oncologist may also conduct a hysterectomy if the cancer has spread substantially. Chemotherapy and radiation therapy may be used post surgery to kill the cancerous cells.
Prevention: Research is going on to find ways and means to prevent this cancer. However, there are some risk factors to consider. Caucasian women are more susceptible to this cancer. Also, women who are above fifty years of age, or have a family history of fallopian tube cancer, ovarian cancer, and breast cancer, or have genetically acquired the BRCA1 gene are at a higher risk.
Pelvic Inflammatory Disease
It occurs when the bacteria spreads from the cervix to the upper genital tract. If it is not detected at the right time, it may cause scar tissues and abscess in the fallopian tubes.
Symptoms: Abdominal pain, pain during urination, and back pain. Other symptoms are vaginal bleeding or discharge, uterine bleeding, fever, vomiting, and fluctuating periods. It can also lead to infertility.
Diagnosis: A pelvic examination will be conducted by your doctor to check the symptoms. He may also check for abscesses around your tubes and ovaries. A series of tests, ultrasound, endometrial biopsy, and laparoscopy may be conducted for further analysis.
Prevention: The easiest way to avoid infection is to take birth control pills. Practice safe sex and avoid multiple partners. Maintaining simple sanitary hygiene like wiping the genital and rectal area clean after urinating and defecating can also help. It is advisable to get a pelvic check-up and screening done at regular intervals.
Treatment: Oral pills and injections are prescribed. A surgery might be needed if an abscess grows on the fallopian tube. It is important that the sexual partners are also treated or the infection may appear again.
Endometriosis
It is a common cause of infertility among women. A tissue similar to the endometrium which grows and sheds during a normal course of menstrual cycle starts building up outside the uterus. It also grows on the ovaries and fallopian tubes, and causes considerable damage. It is usually genetic.
Symptoms: Pelvic pain, painful menstrual cycle, pain during urination and passing stools, and intercourse. One may also face difficulty in conceiving.
Diagnosis: A pelvic examination is conducted by the medical practitioner. He may also conduct a laparoscopy to confirm the diagnosis. If the doctor finds a pelvic mass, he may ask you to go for an MRI, CT scan, and ultrasound to rule out the possibility of ovarian endometrioma.
Treatment: Women suffering from endometriosis are subjected to a hormone therapy which involves oral contraceptives, Gonadotropin-releasing hormone (GnRH analog), and Non-steroidal anti-inflammatory drugs (NSAIDs). Laparoscopy and laparotomy are used to treat endometriosis. The doctor might also suggest hysterectomy if there is severe damage.
Prevention: Endometriosis cannot be completely prevented but it can be cured. Meticulously taking the medicines prescribed by the doctor can definitely reduce the severity of the disease.
Other than these, you may also experience pain if you have undergone tubal ligation procedure or its reversal. As most of these causes can affect fertility, you have to be very careful. If you experience pain anywhere near your lower abdomen, do not waste time and consult your health practitioner who will conduct appropriate tests to find the root cause of the problem.
Disclaimer ~ This HerHaleness article is for informative purposes only, and should not be used as a replacement for expert medical advice.