原作者：
来源Pictures of Pelvic Pain Causes: Cysts, Endometriosis, Fibroids, and More
译者Oyl1983
Slideshow: What's Causing Your Pelvic Pain?
健康图文：是什么导致了你的盆腔疼痛？
Reviewed by Louise Chang, MD on August 04, 2010
由洛卡斯.张提供 MD网站 2010年8月4日
What Is Pelvic Pain?
什么是盆腔痛？
Pelvic pain refers to pain in the abdomen below the belly button. This pain can accompany a wide range of conditions. It may be a harmless sign of fertility, a digestive disorder like IBS, or a red flag for a life-threatening emergency. In the slides ahead, we explore 18 causes of pelvic pain. But be sure to see your doctor for proper diagnosis and treatment.
盆腔痛是指发生在腹部脐部以下的疼痛。许多情况都可表现为盆腔疼痛。它可见于怀孕时候出现的生理性的征象，也可见于类似于消化功能的紊乱如肠易激综合症（IBS），或者是有生命危险急症的象征。在以上的图片中，我们展示了18种导致盆腔疼痛的常见原因。但是要确诊还是应当到医院就诊从而提供确切的诊断以及采取相应的治疗措施。
Appendicitis
阑尾炎
This is an inflammation of the appendix, a tube of tissue connected to the large intestine. The symptoms include sharp pain in the lower right abdomen, vomiting, and fever. If you have these symptoms, go to the ER. An infected appendix must be surgically removed or it will eventually burst, spreading the infection within the abdomen. This can result in life-threatening complications.
阑尾是一条连接结肠的管状组织。该组织产生炎症反应导致阑尾炎。其症状有右下腹的刺痛、呕吐以及发热。如果你出现了上述症状，请马上去医院急诊就诊。在治疗上感染了的阑尾必须通过手术切除。否则最终阑尾会穿孔从而导致肠道内粪便进入腹腔导致感染扩散。这种并发症可导致生命危险。
Irritable Bowel Syndrome (IBS)
2.肠易激综合症（IBS）
Irritable bowel syndrome (IBS) is a chronic digestive disorder that causes recurring belly pain, cramps, bloating, and diarrhea or constipation. Doctors don't know what causes it, but there are strategies to control the symptoms. These include diet changes, stress management, and medications to treat diarrhea or constipation.
肠易激综合症（IBS）是一种慢性的消化系统功能紊乱的综合症。其主要症状有脐周疼痛、腹痛、腹胀以及便秘或腹泻。该病的具体机制尚不清楚，但是可以通过一系列的治疗措施来缓解症状。主要包括改变饮食结构，自我调节缓解生活压力，以及通过药物的方式治疗便秘或腹泻症状。
Mittelschmerz (Painful Ovulation)
3.痛经（痛苦的排卵过程）
If you have painful twinges halfway between your periods, you may be feeling your body ovulate. During ovulation, the ovary releases an egg along with some fluid and blood, which may irritate the lining of the abdomen. This is called mittelschmerz from the German words for "middle" and "pain," because it occurs mid-cycle. The pain may switch sides from month to month. It isn't harmful and usually goes away within a few hours.
在你月经周期过半的时候如果你感觉到疼痛，此时你感觉你的卵巢正在排卵。在排卵过程中，卵巢会排出一个卵细胞并夹带有少量的液体及血液。除卵细胞之外的物质可激惹腹膜。“经期间痛”这个词来自于德语中的“中间”和“疼痛”两个词，由于它发生在两次月经之间。这种疼痛可能在不同月份会出现在不同身侧。其本身对身体无害，而且经常在很短的几个小时内就会缓解。
PMS (Premenstrual Syndrome)
4.PMS（经前综合症）
PMS is known for triggering mood swings and food cravings. It can also cause abdominal cramps, low back pain, headaches, tender breasts, and acne. Hormonal changes may be to blame. Stress, lack of exercise, and some vitamin deficiencies may make the symptoms worse. If PMS is interfering with your daily activities, talk to your doctor. Lifestyle changes and medication can often help.
经前综合症常因情绪变化及食欲减退而被大家所熟知。常常也会伴随腹部绞痛、下腰痛、头痛、乳房变软以及痤疮增加。体内激素的该病是这些症状的罪魁祸首。生活压力、缺少运动以及部分维生素的缺乏会使这些症状加重。如果经前综合症影响了你的日常生活，请告诉的医生，生活方式改变和药物常常有助于症状的缓解。
The chart shows hormone changes during a normal menstrual cycle.
上图显示了一个完整的月经周期中女性体内激素的改变。
Menstrual Cramps
5.月经痛
Every month, the uterus builds up a lining of tissue called the endometrium, where an embryo can implant and grow. If you don't get pregnant, the lining breaks down and leaves the body as your menstrual period. Menstrual cramps can occur when the uterus contracts to help push out this blood. The cramps are usually felt in the lower belly or back and last one to three days. A heating pad and over-the-counter pain relievers may help.
在每个月里子宫会重建衬于子宫内部的称为子宫内膜的组织。子宫内膜是胚胎植入及成长的场所。如果你没有怀孕，那么在每个月经期子宫内膜就会脱落并排除体外。当子宫收缩以利于将内膜组织排除体外时会导致月经痛。这种疼痛常出现在脐部以下或背部，往往可持续1-3天。电热毯以及非处方的止痛药可能会对缓解这类疼痛有效。
Ectopic Pregnancy
6.异位妊娠
This is a life-threatening emergency that requires immediate treatment. It happens when an embryo implants and begins growing somewhere outside of the uterus, usually the fallopian tube. The symptoms include sharp pelvic pain or cramps (particularly on one side), vaginal bleeding, nausea, and dizziness. Urgent medical attention is needed.
这是一种一经发现必须马上处理的危及生命的急症。常常出现于胚胎在子宫以外的部位植入并已经开始发育，而这种植入部位常常位于输卵管。常伴随的症状主要有剧烈的盆腔痛或绞痛（在患侧较为显著），阴道流血，恶心，头晕。一旦出现这种情况必须采取紧急的急救措施。
Pelvic Inflammatory Disease
7.盆腔炎
One of the most serious complications of STDs is pelvic inflammatory disease or PID. This infection can cause permanent damage to the uterus, ovaries, and fallopian tubes (seen here, swollen and red). In fact, it's the leading preventable cause of infertility in women. Symptoms include belly pain, fever, abnormal vaginal discharge, and pain during sex or urination. PID is treated with antibiotics, and in severe cases, surgery.
盆腔炎（elvic inflammatory disease , PID）是性传播疾病并发症最严重的一种。这类感染会导致子宫、卵巢以及输卵管的永久性损伤（如上图所示的红肿部位）。事实上，它也是导致女性不孕不育的首要原因。主要症状包括腹痛、发热、不规则的阴道流液以及性交痛或尿痛。盆腔炎常需要通过抗生素治疗，严重的需要手术治疗。
Ovarian Cysts
8.卵巢囊肿
A follicle houses the maturing egg during the menstrual cycle and releases the egg when you ovulate. Occasionally, a follicle doesn't open to release the egg or recloses after releasing the egg and swells with fluid, forming an ovarian cyst. This is usually harmless and goes away on its own. But large cysts may cause pelvic pain, weight gain, and frequent urination. Ovarian cysts can be identified with a pelvic exam or ultrasound.
正常情况下，女性在月经周期过程中卵巢会形成一个个的容纳成熟卵细胞的类似于房子的结构。通过这种囊状结构在排卵时能够释放卵细胞。但在某些时候，卵泡不破裂释放卵细胞或者在释放卵细胞后再次关闭，这种结构里依然充满了液体，这样就形成了一个卵巢囊肿。本身对人体无害，往往也会自行消失。但是体积较大的卵巢囊肿会会导致盆腔痛，体重增加，以及尿频。卵巢囊肿可通过盆腔检查及超声检查确诊。
Uterine Fibroids
9.子宫肌瘤
Fibroids grow in the wall of the uterus and are sometimes called fibroid tumors, but they are not cancerous. Fibroids are common in women in their 30s and 40s and usually cause no problems. However, some women may experience pressure in the belly, low back pain, heavy periods, painful sex, or trouble getting pregnant. Talk with your doctor about treatments to shrink or remove problematic fibroids.
子宫肌瘤生长于子宫肌壁之间。有时又被称之为肌瘤肿瘤，但是并非代表它们属于恶性范畴。该病常好发于30-50岁的妇女而并无明显症状。然而，部分女性可有腹壁压力高，腰背痛，坠胀感，性交痛，或者怀孕困难。如果碰到这种情况及时就医并制定相应的治疗措施，主要包括缩小或切除有问题的子宫肌瘤。
Endometriosis
10.子宫内膜异位症
In some women, endometrial tissue grows outside the uterus. Growths may form on the ovaries, fallopian tubes, bladder, intestines, and other parts of the body. When it's time for your period, these clumps break down, but the tissue has no way to leave the body. While this is rarely dangerous, it can cause pain and produce scar tissue that may make it tough to get pregnant. There are treatments for endometriosis, but there is no cure.
在一部分女性中，子宫内膜组织生长于子宫之外的地方，子宫内膜生长可以遍及卵巢、输卵管、膀胱、肠道表面以及身体的其他部位。当到了女性的月经期时，子宫内膜在激素调节下会出现脱落，但是在子宫外部的内膜脱落后无法正常排出体外。这是相当危险的，这种情况可引起疼痛以及疤痕组织产生，从而导致怀孕困难。对于该病的治疗措施很多，但是没有一种可以完全治愈。
Urinary Tract Infection
11.泌尿系统感染
A urinary tract infection (UTI) begins when germs get into the urinary tract. A UTI can cause problems anywhere from the urethra to the bladder and up through the ureters all the way to the kidneys. Symptoms include pressure in the lower pelvis, painful urination, and a frequent urge to urinate. The infection usually isn't serious if it is treated promptly. But when it spreads to the kidneys, it can cause permanent damage. Signs of a kidney infection include fever, nausea, vomiting, and pain in one side of the lower back.
泌尿系统感染源于细菌进入泌尿道。泌尿道感染可引起从尿道到膀胱进而经过输尿管上行至肾脏的诸多问题。主要症状包括盆腔底部紧缩感，尿痛、尿频。如果及时治疗通常不会有严重的后果。一旦经泌尿系感染上行至肾脏将会造成永久性的损害肾脏感染常见的症状有发热、恶心、呕吐、一侧的腰背痛。
Kidney Stones
12.肾结石
Kidney stones are globs of salt and minerals that deposit in the urine. They can be as tiny as a grain of sand or as large as a golf ball. As the stones move from your kidney to your bladder, they can trigger sudden, excruciating pain in the belly or pelvic area. Your urine may turn pink or red from blood. Check with your doctor if you think you have kidney stones. Most will pass out of your system on their own, but some require treatment.
肾结石由共存于尿液中的盐和矿物质相互作用形成的。大小可细如沙粒也可大似高尔夫球。当结石从肾脏向膀胱移动时，可突然触发腹部及盆腔的剧痛。尿液由于混合输尿管的出血而呈现出粉红色或红色。如果你觉得你患有肾结石请及时就医。大部分的结石可自行通过泌尿道排出体外，但是仍有小部分需要特殊治疗。
Interstitial Cystitis (IC)
13.间质性膀胱炎（IC）
Interstitial cystitis (IC) is a chronic pain condition related to inflammation of the bladder. The cause is unknown. People with severe IC may need to urinate multiple times an hour. Other symptoms include pressure above the pubic area, painful urination, and pain during sex. The condition is most common in women in their 30s and 40s. Although there is no cure, there are ways to ease the symptoms.
间质性膀胱炎是一种与膀胱炎症导致的慢性疼痛，病因不明。严重的间质性膀胱炎患者出现一个小时小便数次的现象。其他症状还包括耻骨上部位压力增高、尿痛以及性交痛。这种现象在30-50岁的女性中更为常见，虽然没有治愈的方法,但是还是能通过各种方式缓解症状。
Sexually Transmitted Diseases
14.性传播疾病
Pelvic pain is a warning sign for some sexually transmitted diseases (STDs.) Two of the most common are chlamydia and gonorrhea (shown here through a microscope); they often occur together. They don't always cause symptoms, but when they do, they may trigger pelvic pain, painful urination, bleeding between periods, and abnormal vaginal discharge. It's important to seek treatment to prevent serious complications and avoid infecting your partner.
盆腔疼痛常常作为性传播疾病（sexually transmitted diseases ,STDs)）的一种警示信号。最常见的两种病原体是衣原体和淋球菌（上图即为显微镜下的形态）；这两种疾病常相伴而行。感染了这类疾病并不一定会有症状，一旦有症状即会诱发盆腔痛、尿痛、月经周期的之间阴道流血以及不规则阴道流液。确诊此病后寻求治疗措施防止严重的并发症以及避免性伴侣感染是很重要的。
Pelvic Organ Prolapse
15,盆腔器官脱垂
Many women will have some type of pelvic organ prolapse as they age. This occurs when an organ, such as the bladder or uterus, drops into a lower position. It usually isn't a serious health problem, but it can be uncomfortable. The most common symptoms are pressure against the vaginal wall, feeling full in the lower belly, discomfort in the groin or lower back, and painful sex. Treatment options range from special exercises to surgery.
随着年龄增长，部分女性一些位于盆腔的器官会出现脱垂现象。这样的一些器官包括膀胱、子宫会下降到一个较低的位置。通常情况下这并不会对健康造成多大的影响，但是会给人带来不适。最常见的现象就是对阴道壁的挤压感、下腹部的饱胀感，腹股沟区或腰骶部的不适感，性交痛，治疗上主要包括特殊的锻炼方式以及手术。
Pelvic Congestion Syndrome
16.盆腔充血综合症
Varicose veins commonly occur in the legs (seen here in the upper thigh), and they can sometimes develop in the pelvis. Blood backs up in the pelvic veins, causing them to become swollen and painful. This is known as pelvic congestion syndrome. The pain tends to be worse when you sit or stand. Lying down may provide relief. There are minimally invasive procedures to treat pelvic congestion syndrome.
静脉曲张常发生于腿部（上图所示的为大腿根部的静脉造影图），但它有时也可进展至在盆腔，血液淤积在盆腔静脉中，从而导致水肿及疼痛，这就是所谓的“盆腔充血综合症”。这种疼痛的特点表现在当你坐着或站着时疼痛会加剧，而当你躺下时疼痛会得到缓解。现在已经可以通过微创的技术来治疗这种疾病。
Scar Tissue
17.疤痕组织
If you've had surgery in the pelvic or lower abdominal region, such as an appendectomy or a C-section, or infection in the area, you could have ongoing pain from scar tissue. Adhesions are a type of internal scar tissue that forms between organs or structures that are not meant to be connected. Abdominal adhesions can cause pain and other problems, depending on their location. In some cases, adhesions must be surgically removed.
如果你既往有过类似于阑尾或剖腹产的盆腔或者下腹部区域的手术或者这些区域的感染，你可能已经在承受着疤痕所带来的持续的疼痛。粘连是一种内部的组织疤痕，导致原本意义上不相连的组织或结构变成一个整体。腹部粘连根据其位置不同可导致疼痛或其他一系列的问题。某些情况下，这些粘连需要手术切除。
Vulvodynia
18.外阴疼痛
Vulvodynia is chronic vulvar pain that has no known cause. The pain affects the area around the opening of the vagina. It can be constant or recurring and is often described as a burning, stinging or throbbing sensation. Riding a bike or having sex may make the pain worse. It is not caused by an infection. And a diagnosis of vulvodynia is made only after ruling out other causes of vulvar pain. Treatment options range from medication to physical therapy.
外阴疼痛是指无明显诱因下的慢性会阴部的疼痛。疼痛的部位常波及外阴周边，可单次发作，也可反复发作，患者主观症状常描述为烧灼感、针刺感或搏动感。骑自行车或性生活时症状可加重。该病与感染无关。外因疼痛是一个排除性的诊断。治疗上主要是药物治疗和理疗。
Pain During Sex
19.性交过程中的疼痛
Pain during sex (dyspareunia) can be caused by many of the conditions we've discussed, most of which are treatable. Other reasons for painful sex are vaginal infections or insufficient lubrication. Sometimes there is no medical explanation for pain during sex. In those cases, sexual therapy may be beneficial. This type of therapy can help resolve inner conflicts about sex or past abuse.
在以上的已经讨论过的原因中有多数可以导致性交过程中的疼痛（性交痛），而且其中绝大多数是可以治愈的。导致性交痛的其他原因还包括阴道感染或者是阴道润滑不够。有时候会出现医学上暂不能解释的性交痛。在这部分病例中，是可从性心理治疗中获益。治疗的内容主要包括帮助当事人缓和内心冲突以及从过往的滥交生活中解脱出来。
Chronic Pelvic Pain
20.慢性盆腔疼痛
Chronic pelvic pain occurs below your belly button and lasts at least 6 months. It may be severe enough to interfere with your sleep, career, or relationships. The first step toward getting your life back is seeing your doctor for a diagnosis. Most of the conditions we've discussed respond well to treatment. Sometimes, even after a lot of testing, the cause of pelvic pain remains a mystery. But your doctor can still help you find ways to feel better.
慢性骨盆疼痛是指发生在脐部以下至少持续6个月的盆腔疼痛。其严重程度足以影响你的睡眠、事业或社会关系。让你生活回归正轨第一部就是应当就医而得到正确的诊断，大部分的病因我们在上面部分中已经提及并能够得到较好的治疗。当然也存在这样一种情况，那就是即便是做了很多方面的检查疼痛原因仍不明确。但你的医生终归会通过一定的方式使你能够尽量减少痛苦。
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