Pelvic and Abdominal Pain
(and endometriosis) by Frederick R. Jelovsek MD
Intermittant lower abdominal pain
I am 26 years old and experiencing diffuse, intermittent lower abdominal pain. No vaginal discharge. No pain on urination. Menstrual cycle has been erratic, both in frequency and duration. Also experiencing minor fatigue, though I’m not sure it’s related. There is a history of breast cancer in my family. Any help would be appreciated.
Need to know what makes the pain worse and is there any thing that makes it better? Also is it related in any way to the menses even though they are irregular (and how irregular?)? How intermittent is the pain and is it associated with sexual relations, use of tampons etc.?
Nothing makes the pain worse but lying on my side seems to make lessen the pain a bit. It is not related to menstruation. My cycle varies sometimes a couple of weeks. I’ve had many occasions where I’ve missed a cycle.
And lastly the pain is not associated with sexual contact and I do not use tampons. The pain is intermittent, occurring on and off from day to day. But the pain is not constant, meaning it does not occur 24 hours a day.
Assuming the pain does not get worse or better with either bowel movements or with passing your urine and you don’t have an abnormally high frequency of voiding or passing stool, the next step would be to have an abdominal pelvic ultrasound to see if there are any anomalies of the ovaries or uterus.
What may be going on is very difficult to say without an exam. The only abnormality you describe except for the pain is menstrual irregularity. While this can be due to different causes, polycystic ovarian disease comes to mind.
Sometimes it is associated with pain just as recurrent cysts of the ovaries. Sometimes there are endocrine problems such as Addison’s disease.
You have probably looked at the differential diagnosis list for chronic pelvic pain.  As you can see, there are many possibilities.