What is Pelvic Pain

Chronic Pelvic Pain 

U.S. women between 18 and 50 generate more than $800 million in costs for medical treatment for this condition annually. Chronic pelvic pain is challenging for medical providers because the cause is often difficult to determine. Effective treatment frequently requires collaboration among practitioners from various specialties. These patients tend to have related conditions including:

• Problems associated with the bladder or bowels
• Sexual dysfunction
• Feelings of depression and anxiety
• Drug addiction

Women who are of childbearing age are the most likely to experience chronic pelvic pain. It is most common among women between 26 and 30 years of age. In men, the condition is commonly associated with having a swollen or inflamed prostate and testicular pain. 

Causes of Pelvic Pain

There are many reasons why an individual may experience pelvic pain. Miscarriage, menstrual cramps, ovarian cysts, ovarian cancer, pelvic inflammation, vulvodynia and uterine fibroids are a few common causes in women. 

Both men and women may experience pelvic pain due to colon cancer, appendicitis, constipation, Crohn’s disease, fibromyalgia, diverticulitis, inguinal hernia, painful bladder syndrome, kidney stones, irritable bowel syndrome, intestinal obstruction, pelvic floor muscle spasms, ulcerative colitis, prostatitis and urinary tract infection.

The following are lesser known conditions that can also cause pelvic pain. 

Adenomyosis: This condition involves excessive tissue growth along the wall of the uterus. This enlargement of the uterus results in bleeding during menstrual cycles. The specific cause is still unknown and typically does not impact women after menopause. Common treatment options may include hormone therapy or a hysterectomy.

Ectopic Pregnancy: This occurs when a fertilized egg develops outside of the uterus. The egg may be positioned in areas such as the fallopian tube, ovary, or cervix. These pregnancies are not sustainable and bleeding may result that can be life-threatening if not properly treated. 

Endometriosis: This is a painful condition that results from tissue growth outside the uterus among other pelvic organs. During the menstrual cycle, this tissue causes bleeding that results in an accumulation of liquid that has no means of exiting the body. The condition has been linked to cases of infertility. 

Mittelschmerz: Those suffering from Mittelschmerz experience pain during ovulation in the pelvic and abdominal areas. The pain may last for only a few minutes to a span of several hours and there may be some bleeding. In severe cases, the individual may also experience nausea. 

Diagnosis of Pain in the Pelvic Region

Determining the cause of pelvic pain is often challenging. Treatment is generally effective once the correct diagnosis is made. Your doctor may refer you to specialists for testing. Having an examination from a gynecologist is a great starting point, as the condition is often associated with the female reproductive system. 

Diagnostic activities may involve blood work, testing for sexually transmitted infections such as gonorrhea or chlamydia, and pregnancy testing. A urine test may be conducted to determine if there is a urinary tract infection. Imaging tests may be used, including ultrasound, CT scan, or MRI to detect any problems in that region of the body. 

Seeing a Urologist

Urologists can conduct further testing such as for interstitial cystitis, which is inflammation that is not caused by infection. They may use a scope to perform a cystoscopy that may help detect ulcers. A potassium sensitivity test is another diagnostic procedure that may reveal interstitial cystitis as well.

Associated Emotional Problems

Pelvic pain is likely to negatively impact emotional health. Those who suffer from long-lasting pain are understandably more likely to be depressed. There also appears to be a correlation between depression and the worsening of pain that already exists.

Those suffering from pelvic pain often struggle with other aspects of their well-being. They may have difficulty sleeping that leads to lethargic feelings throughout the day. Personal relationships are commonly impacted, such as when pain is experienced due to sexual activity. Many individuals benefit from exercise and/or treatment with antidepressants. 

Difficulty Getting Pregnant

Conditions that cause pain in the pelvic region may impair the ability to become pregnant.  The following are some related facts.  

• Those suffering from endometriosis may be up to 50% less likely to get pregnant.
• Adhesions that develop on the fallopian tubes and ovaries may also lessen the ability to become pregnant.
• Women with uterine fibroids may have difficulty becoming pregnant and may be more likely to experience pregnancy loss. 

Pelvic Congestion Syndrome

The Society of Interventional Radiology reports that pain occurring directly below the navel is often a sign of pelvic congestion syndrome. One cause may be that varicose veins located within the ovaries and pelvis may be enlarged. These veins are used to maintain blood flow to the heart and may swell when blood accumulates. 

The problem of varicose vein enlargement is most common among women who have been pregnant. This may occur because the veins naturally widen to increase blood flow during pregnancy. An ovarian vein embolization can be performed in an interventional radiology setting to treat this condition. The patient is sedated and an incision is made to allow access to the congested veins. 

Treatments for Pelvic Pain

Prescription Medication

Some patients experience pain relief from gabapentin, amitriptyline, or Lyrica. Antidepressant medications are often used such as SSRIs. Medications may be applied topically such as baclofen or estrogen. Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat endometriosis.

Hormone therapy options continue to be developed. These may include contraceptives such as estrogen and progesterone that may be in the form of a pill or patch. Progestin medications are an option that can be administered through injection or as an intrauterine device (IUD). 

Pelvic Physical Therapy

Physical therapy may be used to boost strength, flexibility, and stability. The areas targeted may include muscles and bones near the pelvis to improve the function of the bladder and bowels. Positive results are common because the techniques strengthen the pelvic floor. 

Other Effective Treatments

When the problems involve irritable bowel syndrome, many patients see results by making changes to their diet. Women who are experiencing pelvic pain associated with adhesions or pelvic congestion syndrome often benefit from treatment using medroxyprogesterone acetate. One alternative to a hysterectomy is radiological embolization therapy.    

Effective Treatment Provider for Pelvic Pain in Arizona 

Conditions such a pelvic pain can be difficult to diagnose and there are many potential treatment options. Our medical professionals at Arizona Pain and Spine Institute have many years of experience in successfully treating dozens of painful conditions. Contact us today for an appointment at (480) 986-7246.