Pelvic Pain

Pelvic pain is a term used to describe pain experienced in the area of the pelvis, such as in the uterus, ovaries, vagina, vulva, bowel, bladder and musculoskeletal pelvic structures. Chronic pelvic pain can be constant, or come and go. Pelvic pain is often a warning sign that something may be wrong and should be evaluated promptly.


Causes of Pelvic Pain

There are many gynecologic problems that can result in chronic pelvic pain. Additionally, there are other diseases that may also cause pelvic pain. That’s why it’s important to speak with your physician. Your physician can then help to determine the cause of your pain and formulate an individualized treatment plan that’s right for you.

Some of the most common causes of chronic pelvic pain include:

  • Fibroids (benign muscle tumors of the uterus)
  • Endometriosis (menstrual tissue in the pelvis which leads to pain and inflammation)
  • Adenom
  • yosis (menstrual tissue invasion into the muscle of the uterine wall)
  • Pelvic Inflammatory Disease (PID)
  • Scar tissue (adhesions)
  • Referred back, hip and pelvic muscular or ligament pain
  • Pelvic organ prolapse (relaxation)
  • Ovarian masses or cysts
  • Painful menses
  • Vulvodynia (pain of the labia and vaginal entrance)
  • Interstitial Cystitis (IC) (bladder sensitivity)
  • Other causes, such as infection, irritable bowel syndrome, diverticulitis, kidney or bladder stones, etc.


Treatment Options for Pelvic Pain

Before treating pelvic pain, it’s important to first determine the cause. Because numerous disorders can lead to chronic pelvic pain, it often requires a process of elimination to determine the underlying condition causing the pain.

Therefore, in addition to discussing your symptoms, reviewing your personal health history and family history, and performing a pelvic examination, your physician may order several tests to help determine the cause of your pelvic pain.

Possible tests your doctor may recommend include:

  • Laboratory tests/cultures to determine if infection or disease is present.
  • Imaging studies such as abdominal ultrasound, X-rays, computerized tomography (CT) scans or magnetic resonance imaging (MRI) to help detect inflammation, abnormal structures or growths.
  • Laparoscopic procedures to check for abnormal tissue, or signs of infection in your pelvis, such as endometriosis or chronic pelvic inflammatory disease.

Once the cause is determined, conservative treatment options are often recommended as a first-line strategy. These may include hormone therapy, medication such as medications that calm nerve pain, physical therapy, trigger point injections, and acupuncture.

If first-line treatment options prove unsuccessful, your physician may recommend surgery. During surgery, a physician will remove the disease, such as fibroids, endometriosis or ovarian masses, and correct anatomical abnormalities by removing scar tissue.


Expert Care

At Hoag, our multidisciplinary team of pelvic health experts consists of gynecologists who specialize in pelvic pain, neuropathic pain or referred pain, endometriosis, painful menses (dysmenorrheal) and fibroids; urogynecologists who specialize in the treatment of prolapse, incontinence, overactive bladder and interstitial cystitis; and a sexual medicine specialist who specializes in vulvodynia, dyspareunia (pain with intercourse), sexual dysfunction and counseling.

Hoag’s pelvic health team works together to provide a coordinated approach in the treatment of chronic pelvic pain, including the latest progressive treatment options personalized to meet the needs of the individual patient.

If surgery is necessary, Hoag’s expert team is well versed in the full gamut of minimally invasive laparoscopic techniques, including robotic-assisted surgery utilizing the state-of-the-art da Vinci® Surgical System.

For more information about pelvic pain, please speak with your physician.