Pelvic Pain Management

Pelvic pain is a common problem affecting several women and even men. It is estimated that one in three women suffer pelvic pain in America. The pain is often persistent and may result in lifestyle changes that affect your work, personal relationships, and daily activities. Generally, your entire well-being can be affected. Luckily, there are several treatment options your doctor could recommend for easing your pain. As soon as you start experiencing any symptoms of pelvic pain, you should make an appointment with a doctor. If you are in Los Angeles, our doctors at Gyn LA are readily available to help. Our gynecologists will help relieve your pelvic pain by recommending various medications and other treatment methods, as we will discuss further in this article.

Pelvic Pain Overview

Pelvic pain refers to the pain that occurs in the area between your hips and below your belly button. The pain may last for six or more months. Pelvic pain could be a result of several causes. For instance, it may be an indication of another illness, or it could be a condition developing on its own. If your pelvic pain is a result of another health problem, treating the problem might be adequate to get rid of your pain. However, in most cases, it is usually challenging to determine the sole cause of pelvic pain. If this is the case, then the aim of treatment is to reduce the pain and further symptoms while improving the quality of your life.

Symptoms of Pelvic Pain

Sometimes, pelvic pain may spread over the entire area of your pelvis rather than hitting one spot. Signs that indicate you may have pelvic pain include:

• Steady and severe pain
• Dull aching
• Intermittent pain (the pain lasts for a short time)
• Cramping or sharp pains
• Heaviness or pressure deep in your pelvis

Additionally, you might experience:

• Pain when defecating or urinating
• Pain during sexual intercourse
• Pain after sitting for long hours

Your discomfort can increase when you stand for long hours, and you could relieve it by lying down. Pelvic pain can be mild but annoying. It could also be very severe such that you cannot go to work, sleep, or even exercise.

Causes of Pelvic Pain

Several factors can cause pelvic pain. Its complexity may make it hard to know the exact cause. Sometimes, one disorder might be determined as the cause of this condition. However, in other patients, pelvic pain may be due to several health conditions. For instance, a patient may have interstitial cystitis, which can lead to severe pelvic pain. In other cases, endometriosis can also be the cause of the pain. 

Common causes of pelvic pain are:

Musculoskeletal problems- Health conditions that affect your connective tissues, joints, and bones may result in pelvic pain. These conditions include fibromyalgia, hernia, the tension of the pelvic floor muscles, or pelvic joint inflammation.

Endometriosis- This is a disorder whereby uterine tissues grow outside the uterus. The tissues that grow outside the uterus react to one’s menstrual cycle, the same way the lining of the uterus does. That is, they thicken, break down and bleed each month when hormone levels increase and decrease. Since this takes place outside the uterus, the tissue and blood cannot come out through the vagina. Instead, these components remain in the abdomen, and may eventually result in fibrous bands of adhesions (scar tissue) or painful cysts.

Ovarian remnant- Once you have surgically removed your uterus, fallopian tubes, and ovaries, tiny portions of the ovary can accidentally remain inside. With time, the ovarian remnant develops into painful cysts.

Pelvic inflammatory disease- Pelvic inflammatory disease may be a result of a perennial infection that is usually sexually transmitted. The infection could cause scarring that affects the pelvic organs, resulting in pain.

Irritable bowel disorder- Similar symptoms that indicate one may have contracted irritable bowel disorder may cause pressure and pelvic pain. The symptoms include diarrhea, constipation, or bloating.

Fibroids- Fibroids are non-cancerous growths on the uterine lining. These growths may lead to pressure or heaviness in the lower abdomen. Rarely do these growths cause a sharp pain. They only lead to severe pain if they are deprived of blood supply, then they start to degenerate.

Pelvic congestion disorder- A few doctors believe that varicose-type, enlarged veins around your ovaries and uterus could lead to pelvic pain. But other physicians are not confident that this syndrome is the reason to have pelvic pain. This is because most women that have enlarged pelvic veins do not experience pelvic-related pain.

Interstitial cystitis- This is a painful bladder disorder. This condition occurs due to a frequent urge to urinate and recurring pain in the bladder. You can have pelvic pain as the bladder fills, and the pain may temporarily go away when you empty the bladder.

Psychological factors- Psychological factors like chronic stress, depression, or a history of physical or sexual abuse could increase the risk of pelvic pain. Additionally, emotional distress worsens the pain, and having to live with regularly recurring pain contributes primarily to emotional distress. In the long run, these two factors usually become a vicious cycle.

Pelvic Pain Diagnosis

Determining what is causing your pelvic pain usually involves an elimination process since many different factors can lead to the pain. In a comprehensive interview, your physician may ask you about your pain, personal health record, and family history. He/she can also request you to track the pattern of the pain as well as other symptoms and keep a record. Exams or tests that your physician may suggest include:

Lab tests- When undergoing a pelvic exam, your physician may order the laboratory to check if you have infections like gonorrhea or chlamydia. He/she may also request blood work, which determines blood cell count and urinalysis, which determines if you have any UTI.

Pelvic exam- Pelvic exam can disclose signs of infections, tense muscles of the pelvic floor, or abnormal growths. Your doctor will check if there is an area that has got tenderness. Inform your doctor in case you experience any discomfort when undergoing this exam. This is especially if that pain is the same as what you have been experiencing all along.

Ultrasound- Ultrasound tests use sound waves that have a high frequency to generate exact images of the structures in your body. An ultrasound procedure is mainly useful when trying to detect cysts or masses in the uterus, fallopian tubes, or ovaries.

Other imaging testings- In certain cases, your physician may recommend CT scans, MRI (magnetic resonance imaging), or abdominal X-rays. These tests help to detect abnormal growths or structures.

Laparoscopy- During this procedure, your physician makes a slight incision in the abdomen then inserts a narrow tube that is fixed to a small camera. The camera enables the physician to view pelvic organs to identify any sign of infection or abnormal tissues. This surgical procedure is useful, especially if the doctor wants to detect pelvic inflammatory disease and endometriosis.

The procedure used to determine the primary cause of pelvic pain can be lengthy. In certain scenarios, a definite cause might never be established. However, with open communication and patience, you, together with your doctor, could come up with a treatment plan. The plan may help you live your life fully and with reduced discomfort.

Treating and Managing Pelvic Pain

Pelvic pain treatment aims at reducing the symptoms and enhancing the quality of a patient’s life. In case your physician can determine the specific cause of pelvic pain, then treatment will majorly focus on the cause. But if the specific cause cannot be identified, the treatment focuses on managing the symptoms and pain. For most women, the best approach involves combining a variety of treatment options.

Medications

Based on what’s causing the pain, your doctor might recommend several medications for your condition. For instance:

Pain relievers- There are over-the-counter medications like aspirin or ibuprofen, which may relieve pelvic pain. In certain cases, prescription pain relievers are necessary. However, pain medications alone rarely solve the issue of pelvic pain.

Antibiotics- In case your pain is as a result of an infection, your physician could prescribe antibiotics.

Hormone treatment- In certain women, the days they experience pelvic pain might coincide with a certain stage of their menstrual cycle. The pain could also coincide with hormonal changes that regulate menstruation and ovulation. If this so, birth control pills and other hormonal medications might help treat pelvic pain.

Antidepressants- Certain antidepressants can help treat pelvic pain. Tricyclic antidepressants like amitriptyline seem to contain antidepressant and pain-relieving effects. The medications may relieve the pain even for women who do not have depression.

Surgery

Certain cases would require the doctor to perform surgery to correct the problem that leads to pain. Surgical procedures to treat pelvic pain include:

Hysterectomy- In a few complicated situations, your doctor might recommend that you get rid of your uterus.  He/she may also recommend that your ovaries and fallopian tube be removed as well. There are beneficial health consequences if you undergo these procedures. Your physician will discuss with you the risks and benefits before he/she can recommend this option.

Laparoscopic surgery- In case you have endometriosis, your doctor can get rid of the endometrial tissues or adhesions through laparoscopic surgery. When performing this surgery, the surgeon inserts a laparoscope through a tiny incision near the navel to help/her view the tissues. Then, he/she inserts an instrument that removes endometrial tissues.

Other treatment methods

Apart from medications and surgery, your physician may recommend particular procedures or therapies as ways of treating pelvic pain, including:

Spinal cord stimulation- Spinal cord stimulation involves device implantation to block nerve pathways to prevent pain signals from reaching the brain. This may be useful based on what is causing your pain.

Physical therapy- Massage, stressing exercises, as well as other relaxation methods may relieve your pain. A physiotherapist can help you with the therapies and assist you in developing strategies that will make you cope with the pain. In particular cases, physical therapists target specific places of pain by using transcutaneous electrical nerve stimulation (TENS). This instrument generates electrical impulses to the nearby nerves. Also, physiotherapists may use biofeedback. Biofeedback helps to identify areas that have tight muscles so you can relax them.

Trigger point injections. Your doctor may succeed in pinpointing the exact location where you are feeling pain. In this case, he/she will inject a numbing medication into the painful spot. Usually, the medicine is a local anesthetic and can ease the discomfort and block pain.

Psychotherapy- Pelvic pain may be a result of sexual abuse, depression, troubled marriage, family crisis, or personality disorder. In this case, it may be helpful to seek help from a psychiatrist or psychologist. We have various forms of psychotherapy, like biofeedback and cognitive behavioral therapy. Irrespective of the cause of the pain, psychotherapy helps you develop ways to cope with it.

Pain rehabilitation programs

You should try various treatment methods before settling on what works for you. Also, if it is appropriate for you, you may consider joining pain rehabilitation programs. These programs provide a team’s approach towards various treatment methods, including psychiatric and medical aspects.

Home remedies and lifestyle

Pelvic pain can negatively affect your day to day life. When you are feeling pain, you might find it hard to sleep, exercise, or perform physical tasks. Pelvic pain may also lead to stress and anxiety, which in the long run, may make the pain worse. Relaxation techniques help to reduce pain, release tension, induce sleep, and calm emotions. You can learn many techniques by yourself, for instance, deep breathing and meditation.

Consult a Competent Gynecologist Near Me

Several factors can cause pelvic pain, and it often leads to a significant deterioration in the quality and function of life. Also, note that this problem can affect you at any age or stage in life. Therefore, do not overlook any of the symptoms we mentioned above, however slight they may be. You should see a doctor as soon as you start experiencing any of these symptoms. For patients in Los Angeles, Gyn LA will attend to you in the most effective way. We use a systematic approach when evaluating our patients and then initiate comprehensive pain management strategies. If one method of treatment doesn’t work for you, we will try another until we find the best solution for your pain. Call us now at 310-375-8446 to talk to our doctors about your condition.