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Treating Chronic Pelvic Pain in Women

Jenny L.F. Andrus, MDPlease note****

We do not treat chronic pelvic pain at OSC.   This article is for informational purposes only.

 

 

Jenny L. F. Andrus, MD

Chronic pelvic pain is pain in the area below the bellybutton and between the hips that lasts six months or longer. It can be a symptom of another disease or a condition in its own right. It can affect both women and men, but it is much more common in women. I’m going to discuss chronic pelvic pain and the most effective, available treatments.

There are many possible causes of chronic pelvic pain, such as:

– Endometriosis

– Pelvic inflammatory disease

– Interstitial Cystitis

– Ectopic pregnancy(s)

– Past physical or sexual abuse

– Pelvic floor muscle spasms

– Psychogenic pain – disorder associated with psychological factors

Any of these conditions can be extremely painful and can also exist concurrently with other pelvic issues.  Most women have seen multiple physicians and have undergone many treatments by the time they make their way in for a pain management consultation.

Past treating physicians may have asked about your medical history, performed a physical exam, and ordered diagnostic tests, such as: pelvic ultrasound, laparoscopy, cystoscopy, colonoscopy, and pelvic MRI.

Diagnosis & Treatment of Chronic Pelvic Pain

Usually, women with chronic pelvic pain have a diagnosis, but not always.  That is why most pain management physicians require the past medical records of the patient so they can carefully review them, to see if anything has been overlooked. Diagnosing chronic pelvic pain often involves a process of elimination because many different disorders can cause pelvic pain. It is much like detective work, and physicians must uncover the sometimes “hidden” causes of their patient’s symptoms.

Treatment for chronic pelvic pain depends on the underlying cause and the severity of the pain.  I believe in a multi-modal approach, without using narcotics, unless absolutely necessary. Below is an example of a treatment that many be recommended for chronic pelvic pain:

-If there is an interventional procedure that can be performed, such as a nerve block or a radio frequency ablation, that will provide relief, that should be recommended to the patient.  Often, diagnostic injections can be performed that will provide evidence of whether the procedure will provide relief.

– Pain relievers, such as aspirin, ibuprofen, acetaminophen, or non-narcotic prescription pain relievers

-Nerve calming agents – such as Lyrica or gabapentin, when appropriate, if nerves are involved

-Cymbalta – an anti-depressant which is known to reduce pain

Physical therapy, specifically Pelvic Floor Therapy – to stretch and strengthen the pelvic muscles and improve blood flow and posture

Psychotherapy, to address emotional factors that may contribute to the pain, such as stress, anxiety, depression, or trauma

– Alternative therapies, such as acupuncture, biofeedback, meditation, or yoga

As a woman physician, I understand the emotional and physical toll this type of pain can inflict on a female.  However, effective relief is available for women who have chronic pelvic pain.  Do your research and find a physician who can help.

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