Chronic Pelvic Pain in Women

chronic pelvic pain in womenPelvic pain affects one in four women.  Many women live in silence, not knowing it can be helped. And many women who do seek help may have unnecessary surgeries, such as hysterectomy.

What is pelvic pain?

Pelvic pain is pain or pressure felt anywhere in the abdomen below the navel. It may be intermittent or constant. Many women describe pelvic pain as a dull ache, sharp pains, “toothache” type pain, and/or burning. Other symptoms include pelvic pain/cramps that may be related to menses, or completely independent of a period, pain associated with sex, during or afterward. Women can also have painful ovulation, painful bowel movements, pain with urination, and low back or hip pain.

Pelvic pain in women is complex and can originate from different organ systems such as the female reproductive system, the gastrointestinal system, the urinary system, the musculoskeletal system, the neurological system, or some combination thereof.

Usually, temporary pelvic pain is not a cause for concern and can be treated with over the counter NSAIDS. For more chronic pain, there may be the need for further treatment options, which can include physical therapy, acupuncture, nerve stimulation, amniotic fluid allograft injections.  However, the first necessity is to have an evaluation and determine all the causes of the pain, and what organ systems are affected.  This will require a physical examination and may require cystoscopic and/or laparoscopic evaluation along with possible colonoscopy.

Here to discuss different types of pelvic pain and treatment options is Dr. Barry Jarnagin, urogynecologist with the Incontinence Institute and the Center for Pelvic Health in Franklin, TN:

What symptoms do most women mention when they come to see you for pelvic pain?

Most women complain that their quality of life is greatly diminished by their pain.  They have trouble doing their daily tasks, caring for their children, working, and having an intimate relationship with their partner.

Are there other conditions that bring women in to see you, and then you learn they have pelvic pain?

Many times, women will have urinary and/or gastrointestinal problems (urinary incontinence, urgency, frequency, constipation, and diarrhea) who, after questioning them, admit to chronic pelvic pain and/or pain with sex.

Can pelvic pain be an indicator of a more serious problem?

It certainly can, and a full evaluation is warranted.  And, while most of the time it is a quality of life issue, it needs a full evaluation.

What do you do to treat pelvic pain?

The first and main thing is to evaluate and determine what systems are affected, then develop a treatment plan that will treat all the issues. Many times, there are dietary/behavioral changes that the patient must do along with our treatment protocols. We utilize a multidisciplinary approach with physical therapists trained in the pelvic floor, along with innovative treatments to treat nerves that are affected which are difficult to treat.  We have had much success with the amniotic cell allograft in treating pudendal nerve pain. We also utilize Botox. There are times when laparoscopy with excision of endometriosis, remove a cyst or appendix is necessary. There are many treatment options, most of which are minimally invasive, or not invasive at all.

If you or a loved one are suffering from pelvic pain, schedule an appointment today with our qualified team of doctors at the Incontinence Institute in Tennessee.