Pelvic pain is one of the top reasons for visits to an urgent care, emergency room or a walk in clinic. Most women have experienced some sort of pelvic pain of varying intensity at some point in their life.
Some of the common causes of pelvic pain include endometriosis, dysmenorrhea, pregnancy, UTIs, pelvic inflammatory disease, degenerating fibroids and twisted or ruptured ovarian cysts.
If you are experiencing pelvic pain, there are a number of steps your gynecologist may take to figure out the cause. First, your provider will need a detailed history of how long you have been experiencing the pain, what it feels like, how often and when it occurs. Associated factors such as relationship to menstrual cycle, painful intercourse or urination can guide your gynecologist towards the possible cause.
A complete women’s health exam including a pelvic exam can help elucidate possible pathology. If your doctor finds cervical motion tenderness (pain on palpation of the cervix) or pain while examining the uterus, or surrounding organs, this may indicate pelvic infection or inflammation (PID). PID is treated by a full course of antibiotics, which may or may not include partner treatment depending on test results.
A thorough evaluation includes a sonogram (pelvic ultrasound) to evaluate the uterus for fibroids and/ or ovaries for ovarian cysts etc. Depending on your history, you may also need to do a pregnancy test and be checked for sexually transmitted diseases. If you are experiencing any urinary frequency, pressure or pain with urination, you may be asked to give a urine sample where your urine can be checked for an infection.
Treatment is usually is directed to specific diseases that cause chronic pelvic pain. When there is no clear etiology found for the pain, then treatment is directed to alleviating the symptoms. Treatment options for endometriosis may include oral contraceptive pills, injectable contraceptives, surgery or Lupron.
If your gynecological exam is normal, then non-gynecological reasons need to be ruled out. Remember, the pelvis (lower part of the abdominal cavity) has numerous other organs that can lead to pain. The most common non-gynecologic causes are related to irritable bowel (upset gut) and inflammation of the bowel. Women with these conditions may be suffering from bloating, constipation, blood in stool and heartburn. Most of us tend to ignore our symptoms until they start to affect our quality of life.
Another non-gynecological cause is interstitial cystitis (angry bladder). Women with this condition suffer from long term distressing pain, painful sex and constant lower abdominal discomfort.
The first line treatment for both of the above conditions is lifestyle modification, avoiding spicy foods, drinking at least 10-15 glasses of water a day and eating a health balanced diet.
After a thorough women’s health check up, if the cause of the pain is still an enigma, a visit to a gastro-enterologist and an urologist may be in the pipeline.
If any of the above symptoms have been affecting your daily lives, please feel free to walk in for a complete check up…
Be safe, be ready and be prepared!
Dr. Adeeti Gupta