What Causes Persistent Pelvic Pain In An Anxiety Disorder Patient?

Posted on Wed, 24 Aug 2016

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Wed, 24 Aug 2016 Answered on

Tue, 13 Sep 2016 Last reviewed on

Question : 5 days ago I started having pelvic pain. It was severe enough for me to be a little concerned and it was more intense on the left side. I have pretty intense anxiety disorder so I kept myself up most of that night worrying. I was really stressed and dealing with anxiety already so i was constipated and struggling to go to the bathroom for a couple days so I was hurting from that, too. I also developed an almost bruise looking spot on my left lower pubic region a few months back, but didnt think much of it, but I have a couple more that have come up recently in the same pubic near thigh. I started my period two days ago, and the blood started incredibly dark and changed to a thin bright blood flow, but has since returned to the dark colored kind of dryish blood again with chunks of some type of fleshy substance. I've also been burping quite a lot, but eating really clean and only water. I'm not sure if they have anything to do with my period or not, but today I began breaking out in small spots all over my torso in what appears to be small hives - only they don't itch and they're more of a brown color than red. Also, my pelvic pain has since extended to the lower ribcage area and lower back but still remains more intense on the left side. I've used a heating pad regularly for the last 5 days, but it hasn't helped with the pain or the swelling/bloating. I've been taking low dosages of Xanax to combat any anxiety symptoms. I have since been able to have a healthy bowel movement, but the bloating remains - mostly due to the period I'm assuming. I have so many random symptoms that I have no idea what could be causing this, if its something wrong or me worrying myself to death, but I don't feel like things are right and I'm definitely not bleeding as much as I usually do when I menstruate and I've been dealing with this now since Wednesday night.

Answered by Dr. Bonnie Berger-Durnbaugh (4 hours later)

Brief Answer:
Thoughts on this:

Detailed Answer:
Hello and welcome,

It's possible that you did not ovulate this cycle, and when that happens, the timing and flow can be "off" with more clot/tissue, dark blood, bright red blood, etc. Anovulatory cycles are not uncommon or dangerous, happen more in the teens and early 20s, and are more likely to occur when someone is under stress.

It's also possible that the pelvic pain may be due to the effects of hormones stimulating your ovaries due to an anovulatory cycle (no ovulation).

That said, I think it is important for you to go in to your doctor for a pelvic exam. During the bimanual exam, your doctor can feel the size of your ovaries and check for tenderness. The doctor can also feel over your abdomen to try to localize where the pain is coming from. A pelvic ultrasound can also help sort things out. Sometimes the ovaries can have cysts (usually benign) as a result of attempts at ovulation. With smaller functional cysts (which can cause pain), if they are under a certain size, they are usually left a lone and the body will shrink them over time.

Can I assume you are not at risk for a sexually transmitted disease? Because these can cause pelvic pain in women too.

I looked at the picture of the skin discoloration, and am not sure what to make of it. Best to watch it over time and show it to the doctor when you go in to be checked.

So - your symptoms are not necessarily worrisome, but it would be a good idea to go in for an exam. And if the pelvic pain becomes very painful, then don't wait for an appointment but go in to the ER.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar