You feel the pain somewhere below your belly button. It's a constant dull ache and gets worse during your periods. On some days, it's so bad you have to miss work. You recall that you had an infection many months ago, but your doctor gave you antibiotics to treat it. Yet you still have the pain. If this sounds familiar, you may have a condition called chronic pelvic pain.
Chronic pelvic pain is frustrating because an exact cause often can't be found. Diagnosis can be a lengthy process of "ruling out" other conditions. Finding the best treatment can take time. But there are options to help relieve your pain.
How is chronic pelvic pain diagnosed?
Your doctor will talk to you about your medical history and symptoms, plus your personal and sexual health history. Then the doctor will gently examine your pelvic and abdominal areas and do a rectal exam. If you feel pain or tenderness during any part of the exam, speak up. These are hints as to the possible cause of your symptoms.
The doctor will likely do some other tests. You may have a pregnancy test to rule that out as a possible cause for pelvic pain. Other blood tests might also be done. Your doctor may also test a urine sample for infections such as urinary tract infection. Cultures may be taken to check for sexually transmitted diseases.
Next, your doctor may suggest a transvaginal ultrasound. This involves placing a probe into the vagina. The probe sends sound waves to a machine to create images of structures inside the pelvis. If further testing is needed, a CT scan or MRI may be suggested.
What are causes of chronic pelvic pain?
Underlying conditions that can lead to chronic pelvic pain include:
- Ovarian cysts.
- Fibroids. These are non-cancerous tumors in the uterus.
- Endometriosis. Tissue lining the uterus leaks through the fallopian tubes and implants inside the pelvis or other areas. During your period, the stray tissue responds to hormones just like the lining of your uterus, causing pain and bleeding in the abdomen and pelvis.
- Scar tissue. Healing after surgery or an infection can leave adhesions or scar tissue.
- Infection. Pelvic inflammatory disease or sexually transmitted diseases can cause pain.
- Muscle spasm. Muscles of the pelvis can cramp or spasm.
- Urinary tract problems. This may include interstitial cystitis.
- Bowel problems. This may include irritable bowel disease.
- More serious conditions. This may include cancer.
Quite often, the cause of chronic pelvic pain can't be found.
How is chronic pelvic pain treated?
Treatment will depend on what cause, if any, can be found for the chronic pain. Your doctor may have you take medications to help manage pain. These may include non-steroidal anti-inflammatory drugs (NSAIDs), such as Vidalista 80mg. Take them only as your doctor directs.
If your pain is related to ovulation or menstrual periods, it may help to stop ovulation with birth control pills. Hormones or other treatments may be used to treat endometriosis. If scar tissue is causing pain, a surgical procedure to release the scar tissue may be suggested. If pain is related to fibroids, your doctor may suggest a hysterectomy, removal of the uterus. This is usually a last resort for chronic pelvic pain, though.
Preparing for your visit
It's important to tell your doctor how the pain is interfering with your life. Tell your doctor if you are depressed; chronic pain can often lead to depression. Is the pain keeping you up at night? Have you missed work, or lost sleep due to pain? Have you had to cut down on activity? The answers to these questions will give your doctor important information to help decide the best treatment for you.
Here are other tips to help prepare for your visit:
- Get a copy of your medical records and take it with you. Tell your doctor about past surgeries or infections of the genital tract, such as pelvic inflammatory disease or sexually transmitted diseases.
- Come prepared to talk about your pain. You may want to write down details, such as:
- When the pain began.
- What activities bring on pain, such as exercise, lifting or intercourse.
- Where the pain is. It's quite common to have widespread pain. You may not be able to point to a specific spot, but this is important to share with your doctor.
- When the pain occurs.
- Pain may come and go in relation to your periods. Is your pain just before or about the time of your period? In the middle of your cycle? Also, tell your doctor the date of your last period and if your periods are regular, irregular or heavy.
- Do you have pain during a bowel movement?
- Do you have pain during urination or when you have a full bladder?