Pelvic Pain
Persistent pelvic pain is one of the common complaints experienced by women of reproductive age. It s a common and distressing condition which may result in a woman being unable to work and may affect her self-image and relationships.
Although a common condition it is still not well understood and often the road to diagnosis and effective management is often difficult and frustrating for the patient.
The most common gynaecological causes of pelvic pain include:
- Endometriosis
- Complications of pelvic inflammatory disease
- Ovulation
- Dysmenorrhoea
- Ovarian Cyst complications e.g. rupture, torsion
- Pelvic Floor Dysfunction
Other non-gynaecological causes that may cause pelvic pain include irritable bowel syndrome and inflammation of the bladder.
Initial assessment requires a thorough history and sensitive but comprehensive examination. A history of the pain type, duration, onset and offset, and frequency can provide clues to the possible cause. Past history of surgery, trauma and other conditions may also help to narrow down a diagnosis. Examination would include external examination of the abdomen and genitalia, as well as, internal examination.
Occasionally a working diagnosis may be made at this point and initial treatment can be initiated. Further investigations may be required and include:
- Blood tests
- Swabs and urine specimens for exclusion of infections
- Pap smear / Cervical Screening Test
- Ultrasound
- Laparoscopy
Treatment will be directed to the diagnosis as determined by the above assessment and dependent on the desire for future fertility and best evidence. Treatment may be non-surgical or surgical.
Occasionally the above investigations are all normal and a cause for the pain may not be identified. This may require further investigation of the bowel and bladder. In some ways this can be reassuring to have conditions ruled out.
Chronic Pain management includes not only medical and surgical treatments but can also be successfully treated with coping techniques and techniques to avoid exacerbating factors. It often takes a team of specialists to ensure the best outcomes for you.
