Many women have experienced some kind of pelvic pain. Some pelvic pain is due to an acute condition such as an infection, but sometimes it is chronic and affects a woman’s daily life. The causes of chronic pelvic pain range from common conditions like menstruation to disorders that can damage the entire reproductive system.
1. Menstrual Cramps
Most women have experienced menstrual cramps, or dysmenorrhea, at some point. The throbbing and cramping pelvic pain happens just before and during the menstrual period. Cramps range from a mild annoyance to pain severe enough to interfere with daily activities. Because many women get cramps during each menstrual cycle, it can be considered chronic.
Depending on the severity of the cramps, there are a few treatment options. If the pain is mild, over-the-counter pain relievers can be used. Prescription pain relievers may be given if necessary. Hormonal birth control is often given to reduce the severity of cramps.
2. Ovulation Pain
Some women experience pelvic pain in the middle of their menstrual cycle. This pain, referred to as mittelschmerz (German for “middle pain”), is caused by ovulation. It can cause chronic pelvic pain with each cycle, but it’s usually mild and can be treated with over-the-counter pain relievers. More severe pain can be treated with hormonal birth control to stop ovulation.
3. Recurrent Urinary Tract Infections
A urinary tract infection occurs when part of the urinary tract is infected, but when the bladder is infected, it is called cystitis. Cystitis can cause pelvic pressure and lower abdomen discomfort. Pain is accompanied by frequent, painful urination and there may be blood in the urine. Some women experience frequent, recurring UTIs that cause pelvic pain.
Urinary tract infections are usually treated with a short course of antibiotics, but if you have frequent UTIs you may be prescribed a different antibiotic treatment. You may be put on a low dose of antibiotics for six months or more or take a single dose of antibiotics after sexual intercourse.
4. Ovarian Cysts
Many women have ovarian cysts at some point. They usually don’t cause any noticeable symptoms and disappear without treatment after a few months. However, some ovarian cysts can grow large or rupture and cause serious symptoms including pelvic pain. The pain associated with ovarian cysts is described as a dull or sharp ache in the lower abdomen on the side the cyst is on. Pelvic pain due to ovarian cysts is not always chronic, but if they are caused by endometriosis or a hormonal condition, the pain can become recurrent.
If you are experiencing pelvic pain, you may be given hormonal birth control to prevent cysts from developing. Surgery is also an option if the cyst is large or causes severe pain.
5. Endometriosis
Endometriosis, sometimes referred to as “endo,” is a condition in which tissue similar to the uterine lining grows outside of the uterus. According to the US Office on Women’s Health, it is estimated that more than 6.5 million women in the US have endometriosis. The tissue often grows on the ovaries, fallopian tubes, and tissues lining the pelvic cavity.
Like the uterine lining, endometrial tissue thickens, breaks down, and bleeds during the menstrual cycle. Scar tissue and bands of tissue called adhesions can develop. Chronic pelvic pain is the main symptom of endometriosis. Pelvic pain may worsen during menstruation.
Treatment options for endometriosis vary depending on the severity of symptoms and whether or not the woman wants to maintain her fertility. Pain medication and hormone therapy are often the first treatments prescribed. If symptoms are severe, surgery may be recommended.
6. Uterine Fibroids
Fibroids are muscular tumors that grow in the wall of the uterus. Uterine fibroids are almost always benign or non-cancerous. Fibroids can cause pelvic pain, lower back pain, pain during intercourse, and heavy menstruation. Uterine fibroids may also increase the risk of pregnancy complications.
Women who experience mild symptoms may be treated with medications like pain relievers and iron supplements. Hormonal birth control can help with heavy bleeding and drugs called gonadotropin releasing hormone agonists can shrink fibroids. In severe cases, surgery may be recommended.
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Green Valley OB/GYN has been caring for the women of the Triad for over 70 years. Our physicians are dedicated to providing comprehensive care while continuing to learn about the newest minimally invasive procedures to treat a number of gynecologic problems that cause chronic pelvic pain. If you have concerns about your gynecologic health, call us at (336) 378-1110 to make an appointment.