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. Pelvic pain or menstrual cramps 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 chronic 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 the 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.
The most common gynecologic problems leading to chronic pelvic pain are endometriosis and adhesions.
Once deposited in the pelvis, the cells can attach to surfaces and create implants of endometriosis. These endometriotic implants respond to your cyclic changes: hormones stimulate the implants to grow, and then to bleed internally 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 also lead to serious problems with fertility.
Adhesions, like endometriosis, are a major cause of pelvic pain. Adhesions are areas of scar tissue that attach organs which are normally not normally attached. 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 not only disabling pelvic pain, but also fertility problems.
Adhesions and endometriosis can only be diagnosed visually: there is no blood test, Xray, or sonogram which 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 anything during the procedure or remember any part of it afterwards; women typically return to work after a few days. The information obtained during laparoscopcy can be critical to the proper diagnosis and management of women with pelvic pain and painful periods.
Whether it’s because some gynecologists are not comfortable with laparoscopy, or because they don’t take women’s complaints of pain seriously, most women with pelvic pain are not properly diagnosed and treated. At The Woman’s Health Pavilion, we are committed to finding solutions for patients with pelvic pain: We will work closely with urologists, gastroenterologists, and even your primary care physician to make sure that even non-gynecologic causes of pain will not be overlooked. We work diligently to discover the causes of pelvic pain, and to offer options for effective treatment. Our goal is to provide lasting relief of pain as well as preservation of your fertility, if desired.
Whether it’s because some gynecologists are not comfortable with laparoscopy, or because they don’t take women’s complaints of pain seriously, most women with pelvic pain are not properly diagnosed and treated.
If you suffer from pelvic pain, we invite you to make an appointment for consultation. If other testing has been done—including sonograms, CT scans, MRIs, surgical procedures, or blood tests—it would be best to bring reports with you for your consultation. Effective treatment is available to stop your suffering and help you regain control of your life.
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