Pelvic Pain

Pelvic pain is a common complaint among women. Its nature and intensity may fluctuate, and its cause is often obscure. In some cases, no disease is evident. If your pain lasts longer than a few days or becomes severe without an obvious cause, please call 865-331-1122 to schedule an appointment.

Diagnosing Your Pelvic Pain

Pelvic pain can be categorized as either acute, meaning the pain is sudden and severe, or chronic, meaning the pain either comes and goes or is constant, lasting for a period of months or longer. According to the American College of Obstetricians and Gynecologists, pelvic pain lasting longer than six months and showing no improvement with treatment is known as chronic pelvic pain. Pelvic pain may originate in the genitals or other organs in and around the pelvis, or it may be psychological, which can make pain feel worse or actually cause a sensation of pain, when no physical problem is present.

Symptoms

• Severe cramping with cycles
• Pain with activity
• Pain with intercourse
• Generalized pain throughout the month

Causes

• Endometriosis – the same type of tissue that causes a monthly period can gather outside of the uterus, typically around the ovaries, and cause tremendous pain with cycles, pain in the lower abdomen and pain with intercourse. Treatments can include birth control pills, hormone treatments or laparoscopic surgery. If your case is severe, a hysterectomy may be recommended as a last resort.
• Ovarian cysts and scar tissue – a cyst is a closed cavity or sac that can contain liquid or semi-solid material. Most women will develop small cysts and have no problems, but large cysts cause pain as they grow and stretch the ovary. Scar tissue is the result of a previous surgery or pelvic infection and stretches the ovaries. Both conditions can cause pain with movement. Depending on the severity, ovarian cysts may require laparoscopic surgery.
• Bladder and bowel pain – both the bladder and the bowels are in the pelvis. The pain related to these organs can be intermittent or constant and hard to pinpoint for you and for your doctor. Because of the difficulty in diagnosing these problems, it is vitally important to keep an open dialogue with your doctor.
• Interstitial cystitis (IC) – an inflamed or irritated bladder wall which often causes chronic pelvic pain. IC can lead to scarring and stiffening of the bladder, causing it to not hold as much urine. IC also is known as painful bladder syndrome or frequency-urgency-dysuria syndrome. Dietary changes and medication often provide relief of painful symptoms.
• Muscle pain – the pelvis is lined with muscles which can become inflamed or irritated for no particular reason. Pain typically is severe and worsens with intercourse. Pelvic muscle pain can be felt either at the entrance to the vagina or deeper inside. This can be hard to diagnose, but sometimes symptoms can be successfully treated with physical therapy.

Pelvic Pain Treatments

There are several treatment options depending on the type and severity of your pain. Your physician will discuss which option is right for you.

• Medications
• Dietary changes
• Physical therapy
• Birth control pills
• Hormone treatments
• Laparoscopic surgery
• Hysterectomy

Severe pain is never normal. Schedule an appointment to discuss pelvic pain with your OB/GYN provider.