Pelvic Pain and Painful Periods in New York

Pelvic pain is a surprisingly common problem in women. In fact, about 10% of women seeing a gynecologist make their appointment because of pelvic pain. Pain, especially during a period, can be debilitating, interfering with work, school, or recreation. Even worse, in some cases pelvic pain may indicate a serious problem.

The most common gynecologic problems leading to pelvic pain are endometriosis and adhesions. Endometriosis occurs when the cells that make up the inner lining of the womb start to grow in areas outside womb — on the ovaries, the tubes, or on the surfaces of the pelvis. It's thought that in some cases, these cells are deposited outside the uterus by "backflowing" out of the tubes: Instead of being shed through the vagina with your period, part of the lining flows backwards out of the tubes and deposits in the pelvis.

Once deposited in the pelvis, the cells can attach, and create implants of endometriosis. These endometriotic implants respond to your cyclic changes: hormones stimulate the implants to grow, and then to bleed during your monthly period. The cycle of growth and bleeding can lead to scarring on the internal organs. Typically, women with endometriosis will have significant pain, and severe cramps with their periods. Sometimes sexual relations or passing a bowel movement can cause pain as well. Untreated, endometriosis can lead to serious problems with fertility.

Adhesions, like endometriosis, are a major cause of pelvic pain. Adhesions are areas of scar tissue that connect organs which are normally not connected. They thus create tension due to abnormal pulling of the organs. Many conditions can result in adhesions, but we most commonly see adhesions as a result of prior surgery, pelvic infection, and endometriosis. Once present, adhesions can cause disabling pelvic pain, and also fertility problems.

Adhesions and endometriosis can only be diagnosed visually: there is no blood test, xray, or sonogram that reliably diagnoses these conditions. Visual diagnosis is achieved by performing a procedure called laparoscopy, in which a lighted telescope is placed in the abdomen through the navel, allowing us to view the uterus, tubes, and ovaries directly. Laparoscopy is performed under anesthesia, so you won't feel or remember anything during the case; recovery time is short, and the information obtained is critical in properly diagnosing women with pelvic pain or painful periods.

Whether it's because many gynecologists are not skilled at laparoscopy, or because they don't take women's complaints of pain seriously, most women with pelvic pain do not get properly diagnosed and treated. At The Woman's Health Pavilion, we are committed to finding answers for patients with pelvic pain: We work closely with a urologist and a gastroenterologist so that even non-gynecologic causes of pain will not be overlooked. If you suffer with pelvic pain or painful periods, we can help you understand the cause of your pain, and help develop a treatment strategy that provides lasting relief of pain as well as protection of your fertility.