Pelvic Pain — Investigation and Assessment in London

Pelvic pain is one of the most common reasons women seek specialist gynaecological assessment. It may be acute and sudden in onset, or chronic and persistent — cyclical with the menstrual cycle, or present throughout the month. Whatever its character, unexplained pelvic pain deserves a proper investigation, a thorough investigation. At AristoGP, our consultant gynaecologist provides a thorough, integrated assessment — including same-day specialist pelvic ultrasound — at our Central London EC1 clinic.

Types of Pelvic Pain

Understanding the nature of your pelvic pain is an important part of the diagnostic process. Pelvic pain can be broadly characterised as follows:

Acute Versus Chronic Pelvic Pain

Acute pelvic pain is sudden in onset and typically severe. It usually indicates a condition requiring prompt investigation — such as ovarian cyst rupture or torsion, ectopic pregnancy, or pelvic inflammatory disease. Acute severe pelvic pain, particularly if accompanied by fever, vomiting, or signs of cardiovascular compromise, may require urgent assessment or attendance at an emergency department.

Chronic pelvic pain is defined as intermittent or continuous pain in the lower abdomen or pelvis lasting for six months or more. It is less likely to indicate an acute emergency, but it can significantly affect quality of life and warrants thorough investigation.

Cyclical Versus Non-Cyclical Pain

Cyclical pelvic pain — pain that is clearly related to the menstrual cycle — most commonly suggests conditions such as endometriosis, adenomyosis, or dysmenorrhoea (painful periods). Non-cyclical pain — pain that is present throughout the month regardless of the cycle — may indicate ovarian cysts, fibroids, adhesions, pelvic inflammatory disease, or non-gynaecological causes. Some women experience both cyclical and non-cyclical pain.

Gynaecological Causes of Pelvic Pain

There are many potential gynaecological causes of pelvic pain. Common ones include:

• Ovarian cysts — Fluid-filled sacs on the ovaries that can cause pain when they rupture, bleed, or twist (torsion). Many ovarian cysts are detected on routine pelvic ultrasound and are benign and self-resolving, but they warrant monitoring.
• Endometriosis — A chronic condition in which tissue similar to the uterine lining grows outside the uterus, causing inflammation, adhesions, and pain — often cyclical. See our dedicated endometriosis assessment page.
• Fibroids — Benign uterine growths that can cause pelvic pressure, pain, and heavy bleeding. A fibroid assessment can determine whether fibroids are contributing to your symptoms.
• Pelvic inflammatory disease (PID) — An infection of the upper reproductive tract (uterus, fallopian tubes, ovaries) that can cause acute or chronic pelvic pain. PID requires prompt antibiotic treatment to prevent long-term complications.
• Adenomyosis — A condition in which the uterine lining grows into the uterine muscle wall, causing painful, heavy periods and a tender, enlarged uterus.
• Ectopic pregnancy — Implantation of a fertilised egg outside the uterus (most often in a fallopian tube). This is a medical emergency and causes acute pelvic pain. Any woman with a positive pregnancy test and pelvic pain should seek urgent medical assessment.
• Ovulation pain (mittelschmerz) — Some women experience a brief, sharp pain mid-cycle when an egg is released from the ovary. This is usually short-lived and benign but can occasionally be confused with more serious pathology.

Non-Gynaecological Causes of Pelvic Pain

Not all pelvic pain originates from the reproductive organs. A range of non-gynaecological conditions can cause or contribute to pelvic pain, and distinguishing between them requires a careful assessment:

• Urinary tract infections (UTIs) — Bladder infections frequently cause pelvic pain or discomfort alongside urinary symptoms such as burning and frequency.
• Irritable bowel syndrome (IBS) — A common functional bowel disorder causing cramping, bloating, and altered bowel habit that can closely mimic gynaecological pain.
• Musculoskeletal causes — Pain from the lower back, sacroiliac joints, or pelvic floor muscles can present as pelvic pain and may be exacerbated by the menstrual cycle.
• Interstitial cystitis — A chronic bladder condition causing persistent pelvic pain and urinary urgency in the absence of infection.
• Appendicitis — Acute appendicitis causes right-sided lower abdominal pain and constitutes a surgical emergency.
• Hernia — Inguinal or femoral hernias can occasionally present as pelvic or lower abdominal pain.

At AristoGP, we are well placed to assess this wider differential. Our clinic is co-directed by Dr Schoinas, who operates as a private GP within the same clinical environment. This means that where pelvic pain may have a non-gynaecological component, seamless assessment across specialties is possible within a single appointment or closely co-ordinated follow-up — with seamless cross-specialty assessment within a single visit.

When to Seek Urgent Help

Whilst most pelvic pain warrants planned specialist assessment rather than emergency attendance, there are situations in which you should seek urgent medical help without delay:

• Severe, sudden-onset pelvic pain — particularly if accompanied by shoulder tip pain, dizziness, or feeling faint (which may indicate internal bleeding)
• Pelvic pain with high fever and feeling systemically unwell (suggesting severe infection)
• Pelvic pain in association with a positive or possible pregnancy test
• Pelvic pain with heavy or unusual vaginal bleeding

In these circumstances, please attend your nearest emergency department or call 999. AristoGP is not an emergency service. For all other pelvic pain — whether acute-but-stable or chronic — we are able to arrange a prompt specialist assessment.

Pelvic Pain Investigation at AristoGP

Dr Anastasia Mermigka (GMC 7640566), Consultant Gynaecologist, provides a thorough pelvic pain assessment that integrates clinical expertise with specialist imaging. Your appointment will include:

• Detailed pain history — Exploring the character, site, radiation, timing, and severity of your pain; what makes it better or worse; its relationship to the menstrual cycle; and its impact on your daily life
• Full gynaecological and medical history — Including previous investigations, medications, contraception, and any relevant medical or surgical history
• Pelvic examination on a dedicated gynaecology examination plinth — assessing for tenderness, uterine size and mobility, cervical excitation, and adnexal masses
• Same-day specialist pelvic ultrasound — Using high-resolution equipment to assess the uterus, ovaries, and pelvis for ovarian cysts, fibroids, endometriomas, free fluid, adenomyosis, and any other structural abnormalities. Because the same consultant performs both the clinical examination and the ultrasound, findings are correlated in real time — providing a fully integrated interpretation where clinical and imaging findings are considered together
• Discussion of findings and management plan — Immediate explanation of what has been found and what the next steps are

Our dedicated gynaecology equipment — including a specialist examination plinth and a high-resolution ultrasound machine with both transabdominal and transvaginal capability — supports a thorough and complete assessment. You will not be asked to return for a separate scan on a different day; everything takes place in one appointment.

Depending on findings, further investigations may be recommended — including blood tests, urine culture, or more detailed imaging. Women with a history suggesting endometriosis or fibroids will be assessed within the same appointment. Our full range of gynaecology services ensures that any relevant condition can be assessed and managed from the outset.

For women who would also like a comprehensive health screen alongside their pelvic pain assessment, our Well Woman Check provides a full gynaecological health assessment in a single appointment.

Pelvic Pain Investigation: Pricing

The Gynaecology Consultation + Pelvic Ultrasound is the recommended package for pelvic pain investigation, as ultrasound is an essential part of any thorough pelvic pain assessment.

All fees are transparent and confirmed at booking. Visit our contact page with any questions about pricing or what to expect at your appointment.

Frequently Asked Questions — Pelvic Pain

This page has been reviewed and approved by Dr Anastasia Mermigka, Consultant Gynaecologist, GMC 7640566. Dr Mermigka holds subspecialty training in reproductive medicine and provides consultant-led gynaecology services at AristoGP, Central London EC1.