Pelvic Pain
acute AND cHRONIC PELVIC PAIN
A simple definition of pelvic pain is any pain occuring below the belly button, but not occuring only in the legs or back. Some pelvic pain does radiate or spread to the back or legs. Acute pelvic pain is pain that has been occuring for less than 6 months. Chronic pelvic pain is pain that has been occuring for longer than 6 months. There are also different types of pain, such as pain only with menstrual bleeding, or non-cyclic pain that occurs even when there is no bleeding. Some women have pelvic pain all the time, but the pain is clearly worse during menstrual bleeds. There are also pains associated with urinary function, bowel function and/or movement. There are also several types of pain with intercourse or sex. All of these different types of pain are common among women, and many women come to our office for evaluation of pain symptoms.
Common causes of pelvic pain
Most pain in the pelvis comes from the organs present in the pelvis, meaning from the gynecologic organs (uterus, ovaries, vagina, etc.), from the bowel, from the urinary system (bladder, ureter, or urethra), or the musculoskeletal system (muscles, bones and joints) in the pelvis. Evaluation of pain symptoms is focused on the history/symptoms, findings during exam, and medical history. Imaging such as pelvic and/or abdominal ultrasound, and occasionally other imaging (CT, etc) is also helpful in the evaluation of many pelvic pain symptoms. For some patients, there is also need for procedures such a putting a camera into the abdomen (laparoscopy) or bladder (cystoscopy) to evaluate pain. Some of the most common causes of chronic pelvic pain include irritable bowel syndrome, interstitial cystitis/bladder pain syndrome, pelvic masses such as large fibroids and/or ovarian cysts, adhesions, musculoskeletal problems, and endometriosis.
A long and difficult journey
Many women we see for pelvic pain have had a long and difficult journey getting help, either with correct diagnosis and/or effective treatment. For example, many studies have shown that women with endometriosis usually present to doctors about pelvic pain for several years before the diagnosis of endometriosis is established. If you are having any problems with pelvic pain, we are here to help.
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