Pelvic Or Bladder Pain Disorders Q & A
Q1. What are the causes of pelvic pain disorders?
Some of the common causes of pelvic pain disorders are:
- Endometriosis: Endometriosis is a medical condition in which the tissue from your uterine lining grows in any other place outside the uterus. These tissue deposits react to your menstrual cycle in a manner similar to your uterine lining; i.e. thickening, shedding off and bleeding every month as the levels of hormones rise and fall. Since the tissue deposits lie outside the uterus, the tissue and blood can’t leave the body through the vagina. Instead, they are trapped in the abdomen and may form painful cysts and scar tissue (adhesions).
- Musculoskeletal problems: Certain conditions that affect your joints, connective tissues and bones such as the tension of the muscles of the pelvic floor, fibromyalgia, hernia or inflammation of the pubic symphysis (pubic joint) may result in recurring lower back pain and pelvic pain.
- Fibroids: They are noncancerous growths in the uterus, which may lead to a feeling of pressure in the lower abdomen. They usually don’t cause sharp lower back pain or pelvic pain unless their blood supply is cut off and they start degenerating.
- Interstitial cystitis (Painful bladder syndrome): In this condition, there is recurrent pain in bladder along with frequent urination. Pelvic pain occurs as the bladder fills with urine and it improves temporarily after the bladder is emptied.
- Irritable bowel syndrome (IBS): Pelvic pressure and pain may occur due to the symptoms that are associated with IBS such as constipation or diarrhea and bloating.
- Pelvic congestion syndrome: According to some physicians, varicose-type, enlarged veins around your ovaries and uterus may cause pelvic pain. But some other physicians are less certain whether pelvic congestion syndrome causes pelvic pain as most females who have enlarged veins in their pelvis don’t have associated pain.
- Pelvic inflammatory disease (PID): Pelvic inflammatory disease is characterized by infection and pelvic inflammation of the female reproductive organs including uterus, cervix, fallopian tubes and ovaries. The most common cause of PID is a sexually transmitted disease (STD) such as gonorrhea or Chlamydia. During the early stages, PID may not produce any symptoms. But as the infection worsens you may have pain in the pelvis and lower abdomen, foul-smelling heavy vaginal discharge, pain during sexual intercourse, bleeding between menses, chills and fever and pain during urination. If not treated, PID may result in serious problems; for instance, chronic pelvic pain and trouble in conceiving.
- Ovarian cysts: They are fluid-filled or solid pockets that may form in or on the ovary. They are commonly present in females who are still menstruating. Majority of the time ovarian cysts are harmless and don’t cause pain. They generally go away without any treatment on their own. An ovarian cyst creates a problem if it becomes bigger or doesn’t resolve. It can cause symptoms of bloating, pressure, lower abdominal pain on the side in which the cyst is present and swelling. You may also develop a sharp pain in ovary in some cases that are accompanied by fever, vomiting, dizziness, fast breathing, feeling faint, and weak. These are signs that indicate that your ovary has twisted due to the cyst and needs emergency medical attention.
- Cervical cancer: Cervical cancer in its early stages generally produces no symptoms and signs. In more advanced stages it may produce bleeding from the vagina after sex, between menses or after menopause; foul smelling, bloody and watery vaginal discharge and pelvic pain.
- Uterine cancer: Also known as endometrial cancer, it starts in the cells of the lining of the uterus. The symptoms and signs of uterine cancer are bleeding between menses or after menopause, abnormal, blood-tinged or watery vaginal discharge and pelvic pain.
Q2. What are the symptoms of pelvic pain disorders?
- Steady and severe pain in the lower abdominal area
- Intermittent pain
- Dull aching pain
- Cramping or sharp pain
- Heaviness or pressure deep within the pelvis
You may also experience:
- Pain while having sexual intercourse
- Low back pain
- Pain while sitting for a long duration of time
- Pain while passing urine
- Pain while passing stool
Your pain may worsen after you stand for a long time and may get relieved after you lie down. Pain can be so severe and debilitating that you have to miss work and you can’t exercise and sleep.
Q3 How are pelvic pain disorders diagnosed?
To find out the cause of your pelvic pain your doctor follows a process of elimination as many different medical conditions can cause it. Your doctor will take a detailed history of the pain and other symptoms associated with it and your health and family history.
Your doctor may suggest the following exams or tests:
Pelvic exam: Your physician checks for any areas of tenderness or abnormal growth in the pelvic region.
Lab tests: Your physician may order blood and urine tests to rule out any blood or urine infection.
Ultrasound: This test is done to detect cysts of masses in the ovaries, fallopian tubes or uterus.
Other imaging tests: Your physician may recommend CT scan, abdominal X-rays or MRI to help in detecting abnormal growths or structures.
Laparoscopy: This is a procedure that helps in detecting chronic PID and endometriosis.
Q4. What is the treatment of pelvic pain disorders?
The aim of treatment is to decrease symptoms and signs and to improve life quality. If your physician is able to identify a specific cause of your pain, the treatment is focused on that cause. But if a cause is not identified the focus of treatment is to manage the pain and associated symptoms. Your physician may recommend a combination of different treatments to treat your pelvic pain disorder. The various treatments given are:
Medicines: The different medicines that may be recommended are pain relievers, birth control pills, antibiotics, and antidepressants.
Other therapies: Some of the therapies that are recommended as part of pelvic pain disorder treatment and lower back pain treatment are physical therapy, spinal cord stimulation, and trigger point injections.
Surgery: Surgical procedures such as laparoscopy and hysterectomy are done to correct the underlying problem that is causing chronic pelvic pain.
For treating uterine and cervical cancer radiation therapy and chemotherapy may also be given.
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