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The ligament pulls on nerve fibers and sensitive structures of the female reproductive system. Since the uterus tends to be oriented towards the right side of the body, the pain is also often felt on the right side. This leads to frequent confusion with appendicitis. [6] During pregnancy, the uterus expands to accommodate the growing fetus.
During pregnancy, the enlarged abdomen and gravid uterus place additional strain on lumbar muscles and shift the pregnant woman's center of gravity. These postural compensations culminate in an increased load on both lumbar spinal musculature and the sacroiliac ligaments, manifesting as low back pain and/or pelvic girdle pain. [ 12 ]
Most women, at some time in their lives, experience pelvic pain. As girls enter puberty, pelvic or abdominal pain becomes a frequent complaint. Chronic pelvic pain is a common condition with rate of dysmenorrhoea between 16.8 and 81%, dyspareunia between 8-21.8%, and noncyclical pain between 2.1 and 24%.
Estimates of the percentage of female adolescents and women of reproductive age affected are between 50% and 90%. [4] [6] It is the most common menstrual disorder. [2] Typically, it starts within a year of the first menstrual period. [1] When there is no underlying cause, often the pain improves with age or following having a child. [2]
The condition is typically found in women between the ages of 35 and 50, but also affects younger women. [3] Patients with adenomyosis often present with painful menses (dysmenorrhea), profuse menses (menorrhagia), or both. Other possible symptoms are pain during sexual intercourse, chronic pelvic pain and irritation of the urinary bladder.
The 37-year-old mother was having a rare type of ectopic pregnancy, her doctors said in a case report.
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Hippocratic doctors recognized and treated chronic pelvic pain as a true organic disorder 2,500 years ago, but during the Middle Ages, there was a shift into believing that women with pelvic pain were mad, immoral, imagining the pain, or simply misbehaving. [182]